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RK521  K7221900   Teeth  regulation;  wi 


RECAP 

TEETH  Regulation 


mm 


WITH  FINELY  MADE  ORIGINAL  DEVICES 


Ready  for  Immediate  Operative  Application 


WITHOUT   SOLDERING. 


NUMEROUS  SPECIFIC  ILLUSTRATIONS. 


MILAND   A.   Knapp,  D.D.S. 


SECOND  EDITION,   REVISED  AND  ENLARGED, 


1900  : 
The  S.  S.  White  Dental  Manufacturing  Co. 

Pu'  •■     T  and  Sole  Agent, 

Philal  \,  Pa.,  U.  S.  A. 


RtsS^l 


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Columbia  (Mnttiem'tp 

intlieCitpofillfttjgork 

CoUege  of  ^ftpfiSicians  anb  ^urgeonsi 
iLibrarp 


Digitized  by  tine  Internet  Arciiive 

in  2010  witii  funding  from 

Open  Knowledge  Commons 


http://www.archive.org/details/teethregulationwOOknap 


Teeth  Regulation 


WITH  FINELY  MADE  ORIGINAL   DEVICES 


Ready  for  Immediate  Operative  Application 


WITHOUT   SOLDERING. 


NUMEROUS  SPECIFIC  ILLUSTRATIONS. 


MiLAND    A.    KNAPP,    D.D.S. 


SECOND  EDITION,   REVISED  AND  ENLARGED- 


1900  : 
The  S.  S.  White  Dental  Manufacturing  Co., 

Publisher  and  Sole  Agent, 

Philadelphia,   Pa.,  U.  S.  A. 


Copyright,  1900,  by  Miland  A.  Knapp. 


INTRODUCTION. 


In  the  treatment  and  correction  of  the  typical  cases  of  irreg- 
ularity of  the  teeth  described  and  illustrated  in  the  following 
pages,  the  author  has  attempted  simply  and  plainly  to  give  a 
description  of  the  peculiar  regulating  devices,  the  manner  of 
at  once  applying  or  removing  them,  and  the  method  of  their 
positive  operation  with  safety,  with  restful  intervals,  and  with 
secure  retention.  The  exemplifying  cases  were  chosen  princi- 
pally to  show  the  uses  of  the  different  parts  of  the  devices, 
each  combination  shown  being  immediately  applicable  to  anv 
case  wherein  similar  conditions  exist. 

For  a  number  of  years  the  author  experienced  the  difficul- 
ties attending  this  branch  of  corrective  dental  art,  and  spent 
much  time  in  constructing  appliances  to  accomplish  the 
desired  results,  frequently  making  and  using,  or  attempting 
to  use,  most  of  the  seemingly  practical  appliances  described 
in  dental  literature,  and  all  of  those  oft'ered  for  sale  at  dental 
depots;  some  of  the  last  of  which  are  very  good,  yet  require  a 
great  amount  of  time  to  be  spent  in  soldering  them  together, 
and  after  the  soldering  require  repolishing  or  replating  for  the 
presentation  of  a  respectable  appearance  in  the  mouth.  The 
author  therefore  determined  to  work  out,  by  a  series  of  prac- 
tical experiments,  some  forms  of  devices  that  could  be  imme- 
diately applied  to  the  teeth  without  the  very  tedious  and 
annoying  operation  of  taking  impressions,  making  appliances, 
fitting  them  to  plaster  models,  and  making  soldered  bands  to 

3 


4  INTRODUCTION. 

suit  the  se\-oral  teeth.  (_^)ften  one  would  find  when  the  ca.se 
was  aljout  half  c()m]:)lete(l,  that  some  change  was  necessary 
which  would  re(|uire  a  new  form  of  appliance,  necessitating 
the  loss  of  the  lirst  one  made  and  nearly  all  the  material  used 
in  its  construction.  The  regulating  of  a  case  under  such  cir- 
cumstances proved  to  be  a  very  tedious  and  expensive  opera- 
tion. 

If  operators  were  now  compelled  to  make  from  blanks 
boug'ht  at  dental  depots  burs,  excavators,  pluggers,  clamps, 
etc.,  and  had  to  make  a  new  one  or  lot  for  every  operation 
they  were  called  upon  to  perform,  the  filling  of  teeth  would 
be  a  much  more  tedious  and  expensive  operation  than  it  now 
is,  yet  this  is  what  has  hitherto  been  done  in  nearly  every  case 
of  dental  irregularity  dentists  have  been  called  upon  to  cor- 
rect. 

After  a  long  series  of  experiments  in  practical  work,  the 
author  has  succeeded  in  performing  with  the  regulating  de- 
vices described  in  the  following  pages,  all  the  operations 
usually  met  with  in  practice,  and  he  claims  for  these  devices 
the  following  advantages: 

First:  They  are  ready  to  take  out  of  the  box  and  apply  to 
the  teeth.  No  heating  or  soldering  is  required.  They  are 
therefore  as  neat  in  appearance  in  the  mouth  as  when  removed 
from  the  box. 

Second:  The  several  members  are  as  small  as  is  consistent 
wdth  strength,  they  are  well  plated  to  resist  tarnishment,  are 
accessible  in  all  situations,  and  are  not  liable  to  displacement 
or  loss  by  the  patient. 

Third:  All  the  parts  are  interchangeable,  and  when  an 
extra  member  is  ordered  for  a  special  case,  it  will  work  with  all 
the  parts  on  hand  as  well  as  those  afterward  obtained. 

Fourth:  The  directions  of  force  can  be  changed  in  a  few 
moments  at  any  time  to  overcome  unlooked-for  requirements, 
or  an  entirely  different  device  may  be  put  on  without  the 


INTRODUCTION.  5 

usual  trouble  of  removing  bands  and  soldering  on  new  attach- 
ments. 

Fifth:  The  threaded  l)ars  having  nuts  screwed  on  ready  for 
action  can  be  readily  placed  in,  or  be  taken  from  the  socket 
clutch  bands  while  these  are  fixed  on  the  teeth;  whereas,  in 
other  organizations,  the  nuts  must  first  be  unscrewed,  the 
bar  ends  be  pushed  through  the  band  tubes,  beyond  which  the 
nuts  must  be  again  screwed  onto  the  bar  ends.  This  is  a  very 
tedious  and  troublesome  operation  when  those  bar  ends  ex- 
tend beyond  the  band  tubes  on  second  molars. 

Sixth:  The  several  devices  can  be  used  over  and  over  again, 
and  will  last  as  long  as  some  instruments  commonly  used  in 
dental  practice. 

Seventh:  They  are  time-savers  for  the  practitioner,  and  are 
attractive  to  the  patient. 

Eighth:  The  meml^ers  of  each  organization  are  readily 
separable  for  sterilization  in  hot  water  before  replacement  in 
the  box. 

Ninth:  Every  member  has  its  indicative  number  l)y  which 
it  mav  be  identified  in  description  and  illustration,  and  be 
specified  in  purchasing  orders,  to  be  sure  of  obtaining  the 
desired  part  or  parts  so  numbered. 

Tenth:  The  prices  of  the  parts  are  moderate  in  view  of  their 
convenience,  accuracy,  uniformity,  sightliness,  ready  useful- 
ness, and  durability. 

For  perspicuity  in  depicting  the  several  appliances  in  posi- 
tions upon  and  relative  to  the  anchor  teeth  and  the  teeth  to  be 
moved,  the  portions  of  the  subject  not  necessary  to  be  graphi- 
cally denoted  are  omitted  from  the  illustrations.  The  chief 
object  of  these  is  to  enable  the  operator  to  correct  irregularities 
typified,  or  specified  in  the  depictions,  by  means  of  the 
promptly  applicable  devices  which  are  much  more  clearly 
shown  in  some  situations  when  appearing  on  a  white,  rather 
than  on  a  dark  or  shaded  liackground. 


O  INTRODUCTION. 

Some  of  the  parts  are  too  small  for  clear  delineation,  and 
therefore  associated  and  magnified  or  sectional  views  are  given, 
to  make  obvious  the  constructive  details  or  assemblages  of 
the  several  devices. 

•To  those  who  have  hitherto  employed  thicker  and  heavier 
appliances,  these  thin  and  small  devices  may  seem  inadequate; 
but  the  author  has  in  practice  proved  their  sufficiency,  and  has 
a  firm  confidence  in  their  general  efficiency  when  employed 
with  due  regard  to  the  correct  principles  involved  in  their  con- 
struction and  uses.  A  fundamental  feature  of  the  system  and 
means  is  the  production  of  a  from  time  to  time  progressive 
movement  of  the  tooth  or  teeth  in  the  desired  direction  zvitJwiit 
retrogression.  A  comparatively  weak  initial  and  successive 
push  or  pull  action  will  in  every  suitable  case  be  effective  if  the 
gain  be  unflincliingly  maintained ;  and  this  is  the  function  of  the 
clutch  nut  and  lock  nut  members.  A  moderate  moving  force, 
the  locking  of  the  moving  mechanism,  and  a  timely  repetition 
of  that  process  results  in  a  new  tooth-position  and  a  new  resto- 
ration to  sustain  it:  these  are  the  sources  of  success  in  teeth 
regulation. 

In  this  revised  second  edition,  the  illustrations  are  followed 
by  the  indicating  numbers  of  the  several  appliances  employed 
in  each  figure.  By  this  means,  with  reference  to  the  descrip- 
tion, the  particular  parts  desired  for  a  given  case  may  be  or- 
dered ^v  number  in  every  instance.  In  several  instances,  how- 
ever. No.  30  (the  coil  of  wire)  is  omitted  as  probably  already  in 
hand  by  the  dentist  and  not  needed  in  the  case  illustrated. 

The  author  duly  and  thankfully  recognizes  the  editorial  aid 
afforded  by  W.  Storer  How,  D.D.S.,  in  the  preparation  of 
this  work  for  the  press. 

He  also  appreciates  the  liberal  expenditures  of  The  S.  S. 
White  Dental  Mfg.  Co.  for  the  publication  of  the  volume  in 
neAV,  readily  readable  type,  with  profuse  illustrations,  and  in 
an  excellent  style  of  bibliogony. 


TEETH  REGULATION. 


GENERAL    DESCRIPTION     OF    THE     BUTTON 

BANDS. 

The  bands  used  to  attach  these  apphances  to  the  teeth  are 
open  or  separated  at  the  side  opposite  to  that  from  which  the 
attachments  are  to  be  made.  Each  end  of  the  band  has  a  but- 
ton, around  which  is  to  be  wound  a  wire  thread,  holding  the 
two  ends  of  the  bands  firmly  at  any  required  distance  from 
each  other.  These  bands  are  made  in  ten  sizes,  ranging  from 
the  size  of  the  smallest  incisor  to  that  of  the  largest  molar. 

Fig.  I.  Fig.  2.  Fig.  3.  Fig.  4. 

No.  5. 


No.  5.  S  fl  Xo.  8. 


Sizes  I  to  6,  inclusive,  are  studded  bands,  and  are  used  on  all 
teeth  except  molars.  One  of  these  bands  is  shown  as  wired 
for  use  in  Fig.  i.  Sizes  7  to  10,  inclusive,  are  clutch  bands, 
and  are  to  be  used  on  molar  teeth  for  anchorage.  One  of 
these  is  shown  as  wired  for  use  in  Fig.  2. 

The  bands  most  used  are  Nos.  3,  4,  5,  8.  These  are  the 
sizes  supplied  in  the  sets,  and  will  be  found  to  be  sufficient  for 
many  cases.  Nos.  3,  4,  and  5  are  studded  bands,  and  are  used 
on  the  teeth  which  are  to  be  moved;  they  are  designed  to  fit 

7 


8  KNAPP    SYSTEM. 

bicuspids,  cuspids,  centrals,  and  laterals,  Ijoth  upper  and  lower. 
No.  8  is  one  of  the  double  socket  clutch  bands  like  Fig.  2, 
a  clutch  band  used  for  anchorage  to  the  molars,  and  that  size 
will  be  found  almost  universal  in  its  adjustable  application. 

Each  band  is  adaptable  to  fit  a  variety  of  sizes  of  teeth,  as 
the  ends  of  the  bands  may  be  separated  until  the  buttons 
touch  the  teeth  on  each  side,  or  may  be  brought  so  near  that 
the  buttons  touch  each  other.  The  buttons  also  serve  for 
rotating  wire,  or  other  attachments. 

The  full  range  of  the  band  is  sometimes  limited  by  the 
position  of  the  teeth,  and  a  band  that  will  allow  the  buttons  to 
nearly  touch  becomes  necessary,  as  in  Fig.  3,  which  is  an  illus- 
tration of  a  studded  band  No.  4.  For  this  reason  the  ten 
sizes  of  bands  are  made  to  meet  all  these  peculiarities. 

THE  BUTTON  STUDDED  BANDS. 
Fig.  4  shows  the  studded  band  with  the  threaded  stud  E  at 
the  opposite  side  of  the  band  from  the  buttons.  To  this  stud 
is  to  be  attached  the  ball  cap  of  the  jack-screw,  the  square  T 
socket,  or  the  retaining  devices.  The  square  T  socket,  No.  27, 
may  be  screwed  onto  the  stud  before  cementing  the  band. 

THE  BUTTON  CLUTCH  BANDS. 

The  clutch  consists  of  a  slotted  bar  or  tube  attached  to  the 
band  at  the  side  opposite  from  the  buttons.  See  Fig.  5.  This 
receives  and  holds  firmly  the  anchorage  portions  of  all  the 
devices  used  in  these  appliances,  and  allows  them  to  be  easily 
and  quickly  removed  and  replaced  without  removing  the 
bands  or  the  clutch  nuts  from  the  bars.  This  last  advantage 
will  be  duly  appreciated  by  every  dentist  who  has  had  to  place 
a  nut  on  a  bar  or  wire  after  passing  it  through  a  tube  or  pipe 
fixed  on  a  tooth-band  in  the  mouth.  He  will  well  remember 
his  efforts  to  put  nuts  on  traction  bars  or  wire  arch  bars  pro- 
truding from  the  distal  ends  of  tubes  on  molar  teeth. 

An  enlarged  drawing  of  the  clutch  tube  of  the  double  socket 
clutch  bands  Nos.  7  to  10  is  shown  at  Fig.  6.  A  is  the  band 
to  which  the  partial  tube  B  is  attached.      D  is  the  slot  which 


TEETH    REGULATION. 


receives  the  threaded  bar.  C  C  are  enlarged  portions  or 
sockets  which  receive  the  cyHndrical  portions  of  the  chitch 
nuts. 

When  the  nuts  are  in  position  the  threaded  bar  is  held  firmly 


in  the  tube;  see  Fig.  ly. 


Fig.  7. 


Fig.  7  shows  the  (magnified  cut  in  brackets)  clutch  nut,  the 
rounded  portion  of  which  fits  into  the  socket  C  or  C  of  the 
clutch  tube  B,  Fig.  6. 

TO  APPLY  THE  BANDS. 

First  select  a  band  of  the  proper  size,  and  carefully  work  it 
•on  around  the  tooth  to  be  banded.  Do  not  use  a  mallet  or 
pound  on  the  band.  If  the  teeth  are  very  tight  together, 
press  a  thin  spatula  or  spreader  between  them  on  each  side,  let 
it  remain  a  few  minutes,  and  when  removed  the  band  will  go 
between  the  teeth  easily. 

Burnish  the  band  to  fit  the  irregularities  of  the  tooth  sur- 
face, and  then  fasten  the  w^ire  C  to  the  button  A  on  one  end 
of  the  band,  as  shown  magnified  in  Fig.  8.  Draw  the  wire  C 
tight  around  the  other  l)Utton  B,  Fig.  9.  Then  remove  the 
wire  from  button  B,  being  careful  to  leave  the  kink  in  the  wire 

Fig.  9. 


at  button  B,  which  will  be  a  gauge  to  the  size  of  tooth  after  the 
band  is  removed  from  the  tooth.  Next  remove  the  band 
from  the  tooth  and  replace  the  wire  around  button  B,  giving 
the  wire  two  or  three  cross  turns  in  the  form  of  a  figure  eight 
around  both  buttons,  ending  in  one  or  two  turns  of  the  wire 


lO  KNAPP    SYSTEM. 

around  the  center  of  the  coil,  as  shown  at  D,  Fig.  lo.  The 
band  is  then  read}^  to  be  cemented  to  the  tooth. 

The  teeth  should  be  thoroughly  dried  with  alcohol,  the 
cement  mixed  to  a  sticky  consistence  and  applied  to  the  entire 
inner  surface  of  the  band,  and  the  band  pressed  over  the  tooth 
well  up  to  the  gum.  At  the  same  time  put  a  T  bar — No.  19 
or  No.  20,  or  an  arch  bar  No.  38 — into  the  slot  (D,  Fig.  6) 
in  order  to  fix  the  clutch  tube  in  proper  line  relations  to  the 
teeth,  or  the  bands  on  the  teeth  to  be  moved.  This  precau- 
tion may  render  it  unnecessary  to  bend  the  bar  for  accommo- 
dation to  the  clutch  tube,  as  may  be  requisite  if  the  band 
shall  have  been  fixed  without  regard  to  a  due  alignment  of  the 
clutch  tube.  It  is  better  to  let  the  cement  harden  before 
attaching  the  appliances  to  the  bands. 

To  remove  the  bands,  unwind  or  cut  the  wire,  and  the  band 
may  then  be  easily  removed  from  the  most  sensitive  or  loose 
tooth  without  injury  to  the  tooth  or  band. 

When  bands  are  taken  ofT  they  should  be  immediately 
cleaned  and  sterilized  in  boiling  water,  after  which  they  may 
be  put  away  for  future  use.  Each  band  may  be  used  for  a 
great  many  cases. 

THE  T  BARS. 

Fig.  II. 

The  long  T  bar.  Fig.  11,  or  the  short  T  bar  No.  20,  is  used 
in  all  forward  or  backward  movements  in  a  straight  line;  the 
T  end  fitting  into  the  square  T  socket  No.  27,  while  the 
threaded  portion  is  held  in  the  clutch  tube  by  the  two  clutch 
nuts  No.  22  (see  Fig.  7)  of  the  companion  cut  A,  Fig.  11. 

It  will  be  readily  seen  that  by  turning  these  nuts  in  the 
proper  directions  the  bar  may  be  used  to  either  push  or  pull, 
and  by  tightening  both  nuts  the  bar  is  locked  and  cannot 
become  loosened  by  the  action  of  the  tongue.  When  only  one 
nut  is  used,  the  close  fit  and  friction  of  the  cylindrical  portion 


TEETH    REGULATION.  II 

of  the  clutch  nut  (Fig.  7)  also  keeps  the  bar  from  becoming 
loose  by  tongue  action.  The  square  T  socket,  Fig.  12,  is  a 
bifurcated  head  (see  magnified  cut),  slotted  to  receive  the  T 
head  of  the  T  bar,  and  screws  onto  any  studded  band.  AMien 
screwing  27  onto  a  stud,  do  not  let  the  stud-end  go  quite  tlirough 
the  socket;  else  the  T  of  19,  20,  or  40  will  not  enter  the  socket. 
As  the  T  head  fits  accurately  in  the  slots  of  this  socket  head,  it, 
so  seated,  when  pushing  or  pulling,  prevents  rotation,  but 
allows  the  tooth  to  tip  in  either  line  of  movement;  see  Fig.  17. 
To  insert  the  T  bar,  hold  the  bar  at  about  a  right  angle  to  the 
socket  screwed  onto  the  stud,  and  let  the  T  enter  the  vertical 
slot  until  the  bar  may  be  swung  to  the  right  or  left  and  be 
locked  in  the  socket  No.  27  for  pushing  or  pulling,  as  the  case 
may  be.  The  T  bar  may  be  removed  from  the  square  T  socket 
and  clutch  tube  at  any  time  without  removing  the  bands. 

Fig.  12.  Fig.  13. 


The  round  T  socket  clutch  bar,  Fig.  13,  is  the  swivel-point 
of  anchorage  for  the  T  end  of  the  jack-screw,  and  consists  of  a 
round,  bifurcated  head  connected  to  a  threaded  bar  on  which 
is  a  clutch  nut.  This  fits  into  the  clutch  tube  and  the  bar  is 
locked  in  place  by  tightening  the  nut  in  its  socket.  (See  mag- 
nified cut.)  The  clutch  bar  is  thus  readily  placed  in  the  tube, 
or  by  sufficiently  loosening  the  clutch  nut  may  as  easily  be 
removed  from  the  tube,  without  disturbing  the  clutch  band 
fixed  on  the  tooth. 

THE  JACK-SCREW  COMPLETE,  MAGNIFIED  SECTIONS. 

A  sectional  drawing  of  the  jack-screw  organization  is  shown 
in  Fig.  14.  It  consists  of  an  elongated  nut  No.  25,  right-hand 
threaded  in  one  portion  and  left-hand  threaded  in  the  other. 
The  letter  L  stamped  on  the  long  nut  No.  25  (and  No.  26) 


12 


KNAPP    SYSTEM. 


indicates  the  left-hand  threaded  portion,  which  lits  the  left- 
hand  threaded  l)all  bar  No.  21  (or  No.  33  or  40).  Carefully 
note  the  "L"  in  organizing-  a  jack-screw.  The  short  T  bar 
No.  20  is  screwed  into  the  right-hand  portion,  and  the  ball 
bar  No.  21  into  the  left-hand  portion.  The  ball  cap  No.  24 
incloses  the  ball  of  ball  bar  No.  21  or  33,  and  when  this  cap  is 
screwed  onto  the  stud  of  the  studded  band  No.  5,  this  end  of 
the  jack-screw  is  clamped  firmly  to  the  band. 

The  T  head  of  the  T  bar  No.  20  is  placed  in  the  socket  of  the 
T  socket  clutch  bar  No.  28  and  with  it  forms  a  swivel-joint. 


Fig.  14. 


U  28 


By  unscrewing  the  ball  cap  No.  24  from  the  stud  of  the  band 
No.  5,  the  jack-screw  may  be  swung  backward  and  be  disen- 
gaged from  the  round  T  socket  of  No.  28  and  be  removed 
from  the  mouth  wdthout  removing  the  band. 

At  No.  23  will  be  seen  a  lock  nut  which,  when  tightened 
against  the  long  nut  No.  25,  prevents  it  from  revolving  after 
once  being  tightened,  thus  preventing  the  loss  of  any  move- 
ment once  gained,  as  will  occur  when  the  common  loose  nuts 
are  turned  by  the  tongue  in  the  acts  of  talking,  eating,  or  of 
purpose  by  the  patient,  who  cannot  without  a  wrench  disturb 
these  nut-locked  appliances. 


TEETH    REGULATION.  I3 

Both  the  T  l^ar  and  jack-screw  will  either  push  or  pull  with- 
out changing  the  nuts.  The  T  bars  are  all  made  long  enough 
for  the  longest  reach,  and  will  need  to  be  cut  shorter  for  nearly 
all  cases.  This  is  easily  done  by  first  screwing  a  nut  above 
the  point  where  the  section  is  to  be  made  and  clipping  the 
bar  oil  with  a  wire  cutter:  then  take  a  medium  coarse  file  and 
file  off  the  bulging  portion  caused  by  the  wire  cutter.  The 
flat  side  of  the  file  should  be  placed  perpendicularly  to  the  bar, 
and  when  the  bulge  is  entirely  filed  ofT  the  nut  may  be  turned 
ofif  the  end  of  the  bar  easily. 

When  the  T  bar  of  the  jack-screw  is  to  be  cut,  a  nut  No.  22 
may  be  taken  from  the  round  T  socket  bar  No.  28  and  placed 
above  the  point  of  section,  and  the  bar  cut  as  described  before; 
otherwise  there  will  be  diliticulty  in  getting  the  thread  just 
right  so  that  the  bar  will  enter  the  right-hand  thread  of  the 
long  nut  No.  25. 

When  it  becomes  necessary  to  shorten  the  ball  bar  No.  21, 
it  will  be  also  necessary  to  shorten  the  left-hand  end  of  the 
long  nut  No.  25.  This  may  be  done  by  screwing  the  ball  bar 
into  the  nut  No.  25  a  proper  distance  so  both  points  of  section 
will  be  in  the  same  plane;  then  with  a  suitable  saw  cut  a 
groove  entirely  around  the  nut.  letting  the  saw  just  reach 
through  to  the  ball  bar,  cutting  it  somewhat;  but  care  must 
be  taken  so  as  not  to  cut  the  ball  bar  entirely  ofif. 

If  the  nut  should  be  sawed  off  without  first  placing  the  bar 
inside  far  enough  to  reach  past  the  point  of  section,  it  will  be 
difficult  to  screw  the  bar  in  again,  as  the  feather  edge  of  the 
thread  caused  by  the  saw  will  fill  the  groove  and  prevent  the 
thread  of  the  bar  from  entering. 

The  part  to  be  severed  from  the  long  nut  should  be  entirely 
cut  ofT  first;  then  the  ball  bar  should  be  unscrewed  from  the 
nut,  carrying  the  severed  portion  with  it.  Next,  the  end  of 
ball  bar  should  be  entirely  cut  off  and  the  part  of  nut  above 
point  of  section  screwed  off  the  end.  This  will  clear  the 
threads,  and  the  ball  bar  will  screw  into  the  nut  without 
difficulty.     Keep  carefully  in  mind  the  fact  that  this  end  of  No. 


14 


KNAPP    SYSTEM. 


2^  has  left-hand  threads,  as  also  have  Nos.  21,  33,  and  40;  for 
the  thoughtless  oi)erator  will  turn  them  to  the  right  and  have 
trouble  by  his  own  fault. 

The  parts  of  the  jack-screw  organization,  Fig.  14,  not 
hitherto  separately  shown,  are  depicted  and  denoted  as  follows, 
the  magnified  members  being  in  brackets: 

Long  right  and  left  threaded  nut  No.  25.     OBSi^^^^B 

Short  T  bar  No.  20 

Ball  bar  No.  21. 

Ball  cap  No.  24. 

Studded  band  No.   5. 

Round  T  socket  clutch  bar  with  clutch  nut  No.  28 
2  8  ^3   ■      ^^      ^^j|iiEi(;;;«^^^^^ 
Lock  nut  No.  23. 

Double  socket  clutch  band  No.  8, 


or  single  socket  clutch  band  No.   12. 

The  practical  application  of  the  jack-screw,  in  its  most 
simple  form,  is  shown  in  Fig.  15,  8  being  a  clutch  band 
cemented  to  the  upper  left  first  molar,  with  the  clutch  tube  on 
the  inside  of  the  arch.  In  this  is  placed  the  round  T  socket 
clutch  bar  28.  This  bar  is  held  in  the  tube  by  the  nut  22,  and 
may  be  removed  at  any  time  by  simply  loosening  the  clutch 
nut  and  passing  the  bar  out  through  the  slot,  the  band  re- 
maining on  the  tooth. 

No.  5  is  a  studded  band  cemented  to  the  cuspid,  to  the  stud 
of  which  band  is  attached  the  ball  cap  24.  When  this  cap  is 
screwed  tightly  against  the  ball,  of  ball  bar  21,  the  rotation 
of  the  tooth  to  wdiich  band  5  is  cemented  is  prevented.  If 
the  ball  cap  24  is  screw^ed  on  the  stud  loosely  the  tooth  Avill 
be  free  to  rotate  if  the  pressure  is  in  the  proper  direction  to 


TEETH    REGULATION.  I  5 

cause  rotation.  In  this  manner  teeth  that  need  to  he  both 
placed  in  the  line  of  the  arch,  and  rotated,  may  be  so  placed 
and  rotated  with  this  one  appliance,  by  cementing  the  band 
to  the  tooth  so  the  stud  of  the  band  will  be  at  one  side  of  the 
median  line  of  the  tooth,  and  then  screwing  the  ball  cap  loosely 
on  the  stud. 

If  the  rotation  should  be  accompHshed  before  the  tooth  is 
in  position,  the  tightening  of  the  ball  cap  against  the  ball  will 
stop  the  rotation,  and  there  will  be  no  cause  for  readjusting 
the  band. 

Fig.  is. 


As  the  union  of  the  T  head  of  the  short  T  bar  20  and  the 
round  socket  head  of  T  socket  clutch  bar  28  forms  a  swivel 
joint,  the  ball  cap  may  be  attached  to  the  stud  of  a  band  on  any 
tooth,  from  the  right  second  molar  to  the  left  cuspid  in  the 
case  illustrated. 

If  the  l)all  cap  is  to  be  attached  to  a  band  on  the  left 
central,  lateral,  or  cuspid,  the  clutch  band  8  should  be 
cemented  to  the  left  second  molar  instead  of  the  first  molar 
as  shown  in  the  cut,  or  a  short  right  and  left  threaded  nut  No. 
26  used  in  place  of  the  long  nut  25  shown  in  the  cut. 

The  jack-screw  may  be  removed  by  unscrewing  the  ball 
cap  24  from  stud  of  band  5  and  swinging  it  backward  until  it 
is  about  opposite  the  right  second  molar.      In  this  position 


i6 


KXAPP    SYSTEM. 


it  may  be  lifted  vertically  out  of  the  socket  28  and  removed 
from  the  mouth. 

Fig.  16  represents  the  upper  teeth  of  a  boy  fourteen  years 
old,  with  the  appliances  in  position  for  placing  the  right  cuspid 
in  the  arch. 

The  upper  right  temporary  second  molar  had  been  ex- 
tracted at  an  early  age,  to  relieve  toothache,  and  the  first 
permanent  molar  came  in  too  far  forward. 

When  the  case  came  to  me  the  right  first  bicuspid  had  been 
extracted,  the  person  extracting  it  telling  the  parents  that  the 

Fir;.   16. 


(Nos.  8,  19,  22,  5,  30,  24,  21,  25,  23,  20,  28,  S. ) 

cuspid  would  regulate  itself,  but  as  it  had  been  in  its  present 
position  for  about  two  years  the  parents  came  to  me  to  see 
what  could  be  done. 

It  would  have  been  much  better  to  have  extracted  the 
second  bicuspid  instead  of  the  first,  as  there  was  too  much 
room  for  the  cuspid,  and  space  between  the  bicuspid  and  molar 
would  have  been  better  than  between  the  cuspid  and  bicuspid. 

It  was  necessary  to  draw  the  cuspid  backward  and  inward. 
This  w'as  done  in  one  operation  by  using  both  a  T  bar  and 
jack-screw,  as  shown  in  the  cut. 

A  clutch  band  (No.  8)  was  cemented  to  the  left  first  molar 
with  the  clutch  tube  on  the  inside  of  the  arch,  and  another  to 
the  right  second  molar,  with  the  clutch  tube  on  the  outside  of 


TEETH    REGULATION.  1 7 

the  arch.  A  studded  band  (No.  4)  was  cemented  to  the  cuspid 
with  the  stud  on  the  inside  of  the  arch.  The  patient  was  dis- 
missed until  the  following  day  to  give  the  cement  under  the 
bands  a  good  chance  to  harden,  when  a  T  socket  clutch  bar 
(No.  28)  was  placed  in  the  clutch  tube  of  the  band  on  the  left 
side,  and  a  jack-screw  attached  from  it  to  the  stud  on  the 
cuspid  band. 

A  T  bar  (No.  19)  was  placed  in  the  clutch  tube  of  the  band 
on  the  right  side,  and  a  piece  of  band  wire  (No.  30)  tied  to  the 
T  head  and  passed  around  the  tooth.  The  wire  was  placed 
above  the  stud  and  above  one  button,  and  below  the  other  to 
prevent  it  from  slipping  up  or  down  on  the  tooth.  Traction 
was  applied  as  indicated  by  the  arrows. 

It  will  be  seen  by  referring  to  the  cut  that  the  tooth  will 
move  diagonally  backward  when  both  the  T  bar  and  jack- 
screw  are  tightened. 

And  as  the  tooth  moved  backward  much  more  easily  than 
inward,  the  tightening  of  the  T  Ijar  was  stopped  as  soon  as 
the  cuspid  had  moved  far  enough  to  pass  the  lateral,  and  the 
tightening  of  the  jack-screw  continued  until  the  tooth  was  in 
the  line  of  the  arch. 

As  soon  as  the  cuspid  was  in  position,  the  T  bar,  jack-screw, 
and  clutch  bands  were  taken  off  and  a  retaining  clamp  (No, 
37)  and  nut  (No.  38)  attached  to  the  stud  of  the  cuspid  band, 
the  ends  of  the  clamp  resting  on  the  inner  surfaces  of  the 
lateral  and  bicuspid,  which  held  the  cuspid  firmly  in  position. 

Fig,  17  shows  an  enlarged  sectional  drawing  of  the  T  bar  19 
in  combination  with  the  clutch  band,  square  T  socket,  and 
studded  band  to  which  the  square  T  socket  is  attached. 

No.  8  is  the  clutch  band  which  is  cemented  to  the  molar  or 
anchor  tooth  to  which,  at  the  opposite  side  from  the  opening, 
is  attached  the  clutcli  tube.  This  tube  (see  also  Fig.  6)  is 
permanently  attached  to  the  band,  and  it  will  be  seen  that  as 
the  band  is  rigidly  cemented  to  the  tooth,  the  tube  is  firmly 
held  at  right  angles  to  the  long  axis  of  the  tooth,  thus  pre- 


i8 


KNAPP    SYSTEM. 


venting  the  tooth  from  tipping  when  the  T  bar  is  passed  into 
the  tul)e  and  pressnre  apphed.  In  other  words,  the  apex  of 
the  root  wih  move  as  fast  as  the  crown  of  the  tooth,  which  is 
an  important  feature,  as  it  will  be  found  that  the  anchor  teeth 
move  very  little  when  this  style  of  band  is  used.  ^ 

No.  5  is  the  studded  band,  and  is  cemented  to  the  tooth  to  be 
moved.  No.  27  is  the  square  T  socket  (see  Fig.  12),  which  is 
preferably  to  be  screwed  on  to  the  threaded  stud  of  the  l)and  5 
prior  to  cementing  the  fitted  band. 

No.  19  is  the  T  1)ar,  the  square  T  head  of  which  fits  accu- 
rately the  square  T  socket  27  and  prevents  the  socket  27  from 
rotating  or  changing  position  with  relation  to  the  T  l)ar  19. 

Fig.  17. 


when  pressure  is  applied.  And  as  the  socket  27  is  screwed  on 
the  stud  of  band  5  the  tooth  to  which  the  band  5  is  cemented 
cannot  rotate  with  relation  to  the  T  bar  19,  but  can  tip  forward 
or  backward  whether  the  bar  is  pushing  or  pulling.  In  Fig. 
17  the  T  bar  is  shown  in  the  position  it  would  occupy  in  the 
square  T  socket  27,  when  the  teeth  are  being  drawn  toward 
each  other.  But  if  the  teeth  were  being  pushed  apart  the  T 
head  of  the  T  bar  would  move  to  the  other  side  of  the  square 
T  socket  27,  where  it  would  firmly  seat  itself  and  prevent  the 
tooth  from  rotating  during  movement. 

Nos.  22-22'  are  clutch  nuts  which  move  the  T  bar  forward  or 
backward  through  the  clutch  tube  according  to  the  direction 
the  nuts  are  worked.  If  nut  22'  is  loosened  and  nut  22  tight- 
ened, the  bands  8  and  5  will  be  drawn  together;  and  if  nut  22 


TEETH    REGULATION.  I9 

is  loosened  and  nut  22'  tightened,  the  l^ands  5  and  8  will  l^e 
forced  apart.  During  either  of  which  operations  the  tooth  to 
which  band  8  is  cemented  will  be  held  at  right  angles  to  the 
T  bar  and  the  tooth  to  which  the  Ijand  5  is  cemented  will  be 
free  to  tip  either  forward  or  backward,  but  not  to  rotate. 

It  will  be  seen  by  referring  to  Fig-,  b  that  the  T  bar  is  free 
to  pass  in  or  out  of  the  clutch  tube  through  the  slot  D,  but 
that  when  the  clutch  nuts  22  and  22'  (Fig.  17)  are  in  the 
sockets  C-C  (Fig.  6)  the  T  l)ar  19  is  prevented  from  passing 
through  the  slot  D  (Fig.  6).  It  will  also  be  seen  that  the 
ends  of  the  nuts  22  and  22'  (Fig.  17)  are  concaved  to  lit 
convexed  seats  in  the  clutch  tube,  so  that  when  pressure  is 
applied  the  seats  receive  all  the  pressure  and  the  square  heads 
of  the  nuts  do  not  press  against  the  ends  of  clutch  tulie.  These 
are  important  features,  and  add  greatly  to  the  strength  and 
wearing  qualities  of  the  appliance. 

When  both  nuts  are  tightened  against  the  clutch  tube  the 
T  bar  is  locked  and  may  l^e  left  on  any  length  of  time  without 
fear  of  the  nuts  loosening,  to  cause  the  loss  of  movement  once 
gained. 

An  enlargement  will  l^e  seen  at  the  center  of  square  T 
socket  27,  directly  opposite  the  stud  of  band  5,  the  stud  end 
being  flush  with,  or  slightly  below  the  socket  surface.  This  is 
to  allow  the  T  bar  to  be  moved' to  a  position  at  right  angles  to 
the  position  it  occupies  in  the  cut.  when  both  nuts  22  and  22' 
have  been  loosened  until  they  are  out  of  the  socket  in  the 
clutch  tube  and  the  T  head  of  T  bar  has  l)een  moved  so  as  to 
be  directly  opposite  the  stud  of  the  band  5.  When  in  this  posi- 
tion the  T  bar  may  be  lifted  out  of  socket  27  and  taken  out  of 
the  mouth;  or  be  replaced  in  the  socket  without  removing 
either  the  band  5  or  8,  or  the  socket  27. 

A  practical  application  of  the  parts  shown  in  Fig.  17  is 
illustrated  in  Fig.  18. 

The  upper  right  first  molar  is  used  as  anchorage,  and  the 
first  bicuspid  is  to  be  drawn  backward  into  the  former  position 
of  the  second  bicuspid  which  had  been  extracted. 


20 


KNAPP    SYSTEM. 


Clutch  band  8  is  fitted  to  the  upper  right  hrst  molar,  the 
ends  of  the  band  are  tied  together  with  band  wire  No.  30  and 
the  band  cemented  to  the  tooth  with  the  clutch  tube  on  the 
inside  of  the  arch. 

Studded  band  5  is  wired  and  cemented  to  the  first  bicuspid 
with  the  stud  on  the  inside  of  the  arch  also.  As  soon  as  the 
cement  has  hardened,  square  T  socket  27  is  screwed  to  the 
stud  of  band  5  and  a  T  bar  cut  to  the  proper  length,  which  is 
to  leave  enough  extra  length  of  bar  to  allow  the  clutch  nut  22 
to  be  turned  entirely  oiu  of  the  end  of  the  clutch  tulje  without 


Fig.  18. 


going  off.  the  end  of  the  bar.  The  head  of  the  bar  is  then 
slipped  into  socket  2/:  the  bar  being  held  at  right  angles  to  the 
position  it  occupies  in  Fig.  18,  which  will  allow  the  constricted 
portion  at  head  of  bar  to  pass  through  the  entrance  to  the  slot 
in  27.  The  bar  is  then  given  a  quarter  revolution  backward, 
when  it  will  enter  the  clutch  tube  of  the  band  8.  The  nuts  are 
then  ready  to  be  turned  into  the  sockets  at  either  end  of  the 
clutch  tube,  and  the  appliance  will  be  in  order  for  operation. 

THE  BITE  BANDS. 

When  a  tooth  is  inlocked  it  is  generally  advisable  to  open 
the  bite  while  the  tooth  is  being  carried  over  the  locking 
teeth. 


TEETH    REGULATION.  21 

This  may  be  easily  accomplished  by  the  use  of  the  band 
illustrated  in  Fig.  19.  These  bands  are  wider  than  those 
used  in  regulating  the  teeth,  and  have  four  buttons,  two  of 
which  are  attached  to  one  end,  and  the  other  two  at  some 
distance  from  the  other  end  of  the  band.  This  allows  the 
extra  length  of  band  to  pass  inside  and  close  the  otherwise 
open  space  where  the  ends  of  the  l:>and  are  wired  together  with 
band  wire  No.  30,  making  a  tight  collar  around  the  tooth. 
The  buttons  are  attached  nearer  to  one  edge  of  the  band  than 
the  other,  and  as  this  edge  is  to  go  near  the  gum  the  upper 
part  may  be  trimmed  off  with  shears  if  the  band  is  too  wide 
and  holds  the  teeth  too  far  apart. 

These  bands  are  generally  placed  on  the  lower  bicuspids,  a 
band  on  each  side  of  the  mouth.     In  the  case  of  children,  when 

Fig.  19. 


the  bicuspids  are  not  entirely  erupted,  or  for  other  causes, 
they  may  be  placed  on  the  molars.  It  is  generally  best  to  put 
them  on  the  first  bicuspids,  one  on  each  side  of  the  mouth,  if 
practicable. 

To  place  these  bands  on  the  teeth:  tie  an  end  of  band  wire 
No.  30  to  the  button  nearest  the  end  and  edge  of  the  band; 
next  curl  the  band,  with  the  long  end  inside,  until  it  is  a  little 
too  small  for  the  tooth  and  press  it  over  the  tooth  to  make  a 
tight  fit.  If  the  extra  lap  of  band  should  be  too  long,  and  pass 
between  the  teeth,  causing  two  thicknesses  of  band  between 
the  teeth  on  one  side,  and  the  teeth  should  be  tight  together, 
cut  the  end  of  the  lap  off  enough  to  just  miss  going  between 
the  teeth. 

The  buttons  at  the  bottom  of  the  band,  near  the  gum, 
should  be  drawn  a  little  nearer  together  than  the  upper  ones. 


22 


KNAPP    SYSTEM. 


This  will  make  a  close  fit  around  the  neck  of  the  tooth,  and 
form  a  larger  grinding  surface  at  the  top  of  the  band. 

When  the  band  is  in  position  l)Oth  sets  of  buttons  should 
be  wired,  the  lower  set  first,  and  a  napkin  or  cotton  roll  placed 
around  the  tooth,  and  the  crown  of  the  tooth  and  the  inside  of 
the  band  thoroughly  dried  with  alcohol.  Cement  and  amal- 
gam should  then  be  mixed  (the  cement  rather  thin),  the  band 
filled  two-thirds  full  of  cement  and  the  amalgam  immediately 
placed  on  it,  and  firm  pressure  brought  to  bear  on  the  top  of 
all.     This  will  force  the  cement  all  around  the  crown  of  the 


Fig.  20. 


Fig.  21. 


tooth  and  out  at  the  lower  edge  of  the  band.  This  makes  a 
very  solid  temporary  crown,  proof  against  decay,  and  may  be 
left  on  any  length  of  time  with  no  fear  of  injury  to  the  tooth, 
which  cannot  well  be  done  with  a  soldered  band,  as  it  is  difficult 
to  make  a  proper  fit  at  the  neck  of  the  tooth,  and  if  left  on 
any  length  of  time,  is  liable  to  cause  decay.  The  amalgam 
should  be  so  trimmed  that  the  teeth  will  strike  evenly  on  each 
side.  See  sectional  view  Fig.  20,  in  which  A  represents  the 
amalgam,  B  cement,  C  tooth,  and  D  the  band.  Fig.  19  shows 
the  band  curled  ready  to  be  placed  over  the  tooth.  Fig.  21 
shows  the  band  wired  in  position  on  the  tooth. 

To  remove  the  bands:  Unwind  the  wire,  strip  off  the  band, 
and  remove  the  amalgam  and  cement  with  a  scaler. 

The  bands  should  be  immediately  sterilized  in  boiling  water, 
brushed  with  a  soft  iM'ush  wheel,  and  put  away  for  future  use. 


TEETH    REGULATION, 


23 


CASE  SHOWING  THE  USE  OF  THE  SINGLE  AUXILIARY 
T  SOCKET  No.  31  AND  THE  PERFORATED  STUD 

No.  36. 

Fig.  22  represents  a  case  in  which  the  cuspid  and  lateral 
of  the  upper  right  side  were  thrown  out  of  the  hue  of  arch  by 
the  anterior  root  of  the  first  temporary  molar,  which  remained 
in  the  gum  until  the  ]:)ermanent  teeth  were  all  fully  erupted. 
The  root  was  just  anterior  to  the  first  bicuspid,  occupying 
some  of  the  space  of  the  cuspid.     This  caused  the  cuspid  to 

Fig.  22. 


(.Nos.  9,  28,  20,  31,  23,  25,  21,  24,  4,-5,  24,  30,  36,  21,  25,  23,  20.) 

be  pushed  out  of  line  and  partially  rotated,  and  the  pressure 
of  this  tooth  against  the  lateral  forced  it  inside  the  line  of  the 
arch. 

After  the  root  was  extracted,  enough  space  remained 
between  the  cuspid  and  bicuspid  to  accommodate  the  cuspid 
and  lateral  when  placed  in  position. 

In  treating  this  case  it  w^as  necessary  to  push  the  lateral 
outward  and  to  rotate  and  draw  the  cuspid  inward.  This 
was  done  in  one  operation  with  the  appliances  shown  in  the 
cut. 

A  clutch  band  was  cemented  to  the  left  first  molar,  and 
studded  bands  cemented  to  the  lateral  and  cuspid.  Two 
jack-screws  were  used,  and  to  the  T  bar  of  the  jack-screw 
attached   to  the  lateral,  a  single  auxiliary  T  socket   No.   31 


24  KNAPP    SYSTEM. 

was  attached  to  form  a  base  of  anchorage  for  the  second  jack- 
screw,  which  was  attached  to  the  cuspid.  As  the  cuspid  was 
to  be  both  drawn  in  and  rotated,  it  was  much  quicker  to  do 
both  operations  at  once,  and  instead  of  attaching  the  ball  cap 
directly  to  the  stud  of  the  band  on  the  cuspid,  a  perforated 
stud  No.  36  was  screwed  into  the  ball  cap  and  a  piece  of  band 
wire  No.  30  doubled  and  passed  through  the  hole  in  the  stud. 
The  wire  was  carried  two-thirds  around  the  tooth  and  attached 
to  the  anterior  button  of  the  band.  It  will  be  readily  seen  that 
when  the  long  nut  of  the  jack-screw  attached  to  the  cuspid 
is  turned  to  the  right  this  jack-screw  will  contract,  drawing 
the  cuspid  inward  and  rotating  it  at  the  same  time.  By  turn- 
ing the  long  nut  of  the  jack-screw  attached  to  the  lateral  to  the 
left  this  jack-screw  will  be  lengthened,  pushing  the  lateral  out- 
ward. As  the  jack-screws  are  working  in  opposite  directions, 
and  are  held  firmly  together  by  the  single  auxiliary  T  socket, 
the  push  and  pull  forces  will  be  equalized  or  compensated,  and 
no  strain  will  be  brought  to  l^ear  on  the  anchor  tooth.  The 
cuspid  was  actually  forced  backward  by  the  pressure  from  the 
lateral  as  the  lateral  was  being  forced  outward,  while  the 
rotating  force  applied  to  the  cuspid  also  retrograded  it,  the 
point  of  contact  between  the  cuspid  and  lateral  acting  as  the 
fulcrum. 

RETAINING  DEVICE  FOR  FIG.  22. 
When  the  teeth  had  gained  their  proper  positions  the  jack- 
screws  and  bands  were  all  taken  off,  excepting  the  band  on  the 

Fig.  23. 


(Nos.  5.  37-  38-) 

cuspid  that  was  used  to  hold  the  retaining  device  as  illustrated 
in  Fig.  23.     A  retaining  clamp  No.  37  was  bent  to  overlap  the 


TEETH    PECULATION. 


inner  surfaces  of  the  first  bicuspid  and  lateral  and  was  held  on 
the  stud  of  the  cuspid  band  by  the  retaining  nut  No.  38. 

INSTRUCTIONS  FOR  ORDERING  THE  DIFFERENT 

SIZES  OF  BANDS. 

In  Figs.  24,  25,  26,  and  27  will  be  seen  plane  projections  of 

each  of  the  bands  used  with  these  regulating  devices,  the  cuts 

showing  the  exact   lengths  of  the   several   numbered  bands. 


Fig.  25. 


Double  Socket  Clut(  li  Ha 

Fig.  27. 


Ic  Sim  ket  Clutch  Bands. 

Fig.  28. 


Fig.  2q. 


Fig.  29A. 


Screw  Bands,  Studded. 


Screw  Bands,  Single  Socket 
Clutch. 


Screw  Bands,   Double 
Socket  Clutch. 


Fig.  24  shows  the  six  lengths  of  studded  bands,  Fig.  25  the 
four  lengths  of  double  socket  clutch  bands.  Fig.  26  the  four 
lengths  of  single  socket  clutch  bands,  and  Fig.  27  the  four 


lengths  of  bite  bands. 


When  ordering  these  bands  to  fit  any  special  tooth:  With 
a  piece  of  waxed  floss  silk;  or,  if  the  interdental  spaces  allow, 
binding  wire,  take  a  measure  of  the  tooth  to  l)e  banded  and 


26  KNAPP    SYSTEM. 

compare  the  length  of  the  measure  so  taken  with  the  lengths  of 
bands  in  the  cnts,  and  in  ordering  simply  give  the  number  of 
iJic  baud  that  the  measure  agrees  with. 

If  studded  bands  are  wanted,  compare  the  length  of  the 
measure  with  the  lengths  of  bands  shown  in  Fig.  24  only.  If 
clutch  bands  are  required,  compare  with  lengths  in  Fig.  25 
only,  and  so  on  with  each  class. 

In  Fig.  27,  showing  bite  bands,  the  dark  portions  of  the 
drawings  represent  the  circumferences  of  the  teeth  the  bands 
are  designed  to  tit,  the  dotted  portions  showing  the  extra 
extensions  required  to  make  the  laps. 

At  A,  Fig.  27,  will  be  seen  the  proper  method  of  selecting 
the  number  of  a  bite  band  to  order,  the  line  at  A  representing 
the  measure,  or  distance,  around  the  tooth  to  be  banded. 

If  the  measure  of  the  circumference  of  a  tooth  is  between 
two  numbers,  as  it  generally  is,  always  select  the  lesser  num- 
ber,— e.g.,  if  a  studded  band  is  wanted  and  a  measure  of  the 
tooth  it  is  to  lit  is  taken,  and  the  length  of  the  measure  when 
compared  with  the  lengths  of  bands  in  Fig.  24  should  be  be- 
tween Nos.  4  and  5,  then  select  No.  4. 

Always  select  the  next  size  shorter  than  the  measure  taken 
from  the  tooth  to  be  banded. 

Fig.  28  shows  four  lengths  of  screw  bands,  studded,  each  of 
which  is  capable  of  adjustment  to  fit  several  sizes  of  teeth, 
and  the  same  is  true  of  the  screw  bands  having  the  single 
socket  clutch,  Fig.  29,  as  well  as  the  screw  bands  having  the 
double  socket  clutch  with  lengths  indicated  under  Fig.  29A. 
xA.ll  the  screw  band  measures  denote  the  smallest  sizes  of  the 
bands  for  the  respective  teeth  to  be  fitted,  but  No.  41,  for 
instance,  will  also  fit  a  tooth  having  nearly  the  circumference 
of  the  No.  42  measure.  So  also  of  No.  43,  which  may  be 
expanded  to  almost  the  length  of  44;  No.  44  to  near  45,  No. 
45  to  just  short  of  46  measure,  and  so  through  the  series. 


TEETH    REGULATION, 


27 


THE  SCREW  BANDS. 

These  supplemental  bands  have  some  advantages  in  their 
adjustability  to  teeth  of  various  sizes;  in  being  detachably  nut- 
locked;  in  their  fixedness  upon  the  teeth;  and  in  their  co- 
operation with  the  several  other  members  of  this  system. 
Wherever  the  different  button  bands  are  shown  and  described, 
the  related  screw  bands  may  likewise  be  employed.  For  ex- 
ample,  in  the  illustration  and  description  of  the  jack-screw 


(Nos.  41,  42,  43,44. 


45.  46,  47,  4S. 


49.  50,  51.  52.) 


complete,  Fig.  15,  the  screw  band  No.  43  may  be  substituted 
for  the  button  band  No.  5,  and  the  screw  band  No.  50  take  the 
place  of  the  button  band  No.  8  as  also  in  Fig.  17,  at  the  option 
of  the  operator.  An  example  of  the  combination  of  the  two 
classes  of  bands  is  shown  in  Fig.  30,  where  a  button  band  No. 
12  is  seen  fixed  on  a  cuspid,  and  a  screw  band  No.  51  is  shown 
cemented  onto  a  molar. 


Fig.  30. 


Fig.  31. 


[(Nos.  46,  19,  22,  22,  49.) 
(Nos.  51,  19,  22,  12,  22,  42.) 

A  like  organization  is  illustrated  by  Fig.  31,  wherein  is  seen 
screw  band  No.  49  fixed  on  a  molar  and  screw  band  No.  46 
cemented  on  a  bicuspid.  In  the  new  series  of  twelve  bands, 
the  screws  have  the  diameters  and  threads  of  Nos.  22,  23.  25 
right,  26  right,  31,  32,  33,  and  34;  with  all  of  which  parts  useful 
coml)inations  can  l)e  made. 


28 


KNAPP    SYSTEM. 


In  placing  the  screw  bands,  their  application  is  facilitated 
by  the  freedom  with  which  they  may  be  straightened,  as  shown 
by  Fig.  32.  in  aid  of  the  process  of  passing  them  between  the 
teeth. 

This  illustration  makes  clear  the  constructive  details  of  the 
screw  bands.  The  double  socket  clutch  forms,  Nos.  49  to  52, 
are  here  shown,  and  the  magnified  socket  clutch  on  the  right 
is  described  with  reference  to  letter  indices  in  Fig.  6;  but  this 
magnified  exhibit  of  the  recess-collared  nut  and  the  flanged 

Fig.  32. 


clutch  enables  one  to  see  how  that  slotted  clutch  is  in  opera- 
tion inclosed  by  the  recessed  collar  of  the  nut  which  so 
strengthens  the  flanged  and  slotted  clutch.  Thus  the  ends 
of  the  screw  band  may  be  detached  or  attached  by  simply 
passing  the  screw  out  from  or  into  the  slot  of  the  clutch  when 
the  nut  has  been  suitably  turned.  All  the  screw  bands  have 
this  novel  and  useful  organization. 

The  illustrations  Figs.  33  and  34  show  button  band  appli- 
cations  and   organizations   like    the   screw   band   illustrations 
Fig.  33.  Fig.  34. 


(Nos.  13,  19,  22,  22,  8.) 


(Nos.  S,  19,  22,  12,  22,  34.) 

Figs.  30  and  31.  and  altogether  exemplify  the  uses  of  the 
socket  clutch  bands,  in  connection  with  a  T  bar,  for  drawing  a 
cuspid  or  bicuspid  backward.  In  these  instances  the  moving 
nut  is  located  on  the  anterior  end  of  the  bar  for  convenience 
of  access  in  some  cases  where  the  patient  is  to  use  the  wrench, 
although  the  patient  may  also  operate  the  nuts  when  situated 
behind  the  clutches,  as  in  other  illustrations. 


TEETH    REGULATION.  29 

In  a  case  of  the  kind  here  represented,  a  chitch  band,  as  No. 
8  or  No.  50,  is  cemented  to  the  molar  or  anchor  tooth,  taking- 
care  when  cementing  to  place  a  T  bar  in  the  chitch  tnbe  to 
insure  proper  bar  alignment  with  the  clutch  tube  on  the  tooth 
to  be  moved. 

In  applying-  the  single  socket  clutch  band  to  the  tooth  to 
be  moved,  it  is  important  to  observe  that  the  recess  or  socket 
faces  anteriorly  to  receive  the  roimded  portion  of  the  clutch 
nut  No.  22,  as  may  be  seen  by  a  close  examination  of  the 
banded  cuspid  in  Fig.  30  or  Fig.  33.  Two  clutch  nuts  are  to 
be  screwed  onto  a  T  bar  as  at  A,  Fig.  1 1 ;  the  rounded  portions 
of  the  nuts  tending  toward  the  T.  The  T  bar  is  then  cut  to 
the  proper  length  and  passed  into  the  slots  of  the  clutches,  the 
T  end  back  of  and  resting  against  the  end  of  the  clutch  tube 
on  the  band  of  the  molar,  as  shown  in  the  several  illustrations. 
Thoughtfully  turn  the  nuts  onto  the  bar  before  cutting  it; 
then  by  backing  off  one  nut,  it  can  be  replaced,  or  a  ball  cap 
No.  24  be  screwed  on,  as  shown.  When  the  clutch  nut  No.  22, 
near  the  T  end,  is  screwed  tight  against  the  anterior  end  of  the 
clutch  tube  the  bar  will  be  locked  in  movement  in  any  direc- 
tion. Turning  the  anterior  nut  will  seat  it  in  the  single  socket 
of  the  clutch  tube  of  the  cuspid  or  bicuspid,  which  by  the 
further  tightening  of  the  nut  will  be  pulled  toward  the  anchor 
tooth,  and  neither  of  the  teeth  will  be  tipped  to  any  consider- 
able degree  in  the  moving  process. 

Fig.  35  shows  the  position  of  the  upper  teeth  in  the  mouth 
of  a  girl  twelve  years  old.  The  left  central  was  somewhat 
rotated  and  overlapped  the  right  central,  and  the  left  lateral 
was  inlocked;  the  lower  teeth  striking  between  it  and  the 
central  and  cuspid  when  the  jaws  were  closed. 

The  cuspid  was  in  proper  line,  but  too  far  forward.  The 
mesial  surface  of  the  right  central  was  nearly  on  the  median 
line,  and  as  the  left  first  bicuspid  was  very  badly  decayed  the 
course  indicated  was  to  extract  the  bicuspid  and  draw  the 
cuspid  back  far  enough  to  permit  the  placing  of  the  central 
and  lateral  in  their  proper  positions. 


30  KNAPP    SYSTEM. 

The  first  bicuspid  was  extracted  and  the  regulation  effected 
by  three  operations,  the  first  of  which  is  shown  in  Fig.  36. 

The  upper  left  first  molar  was  collared  with  a  clutch  band, 
the  clutch  being  on  the  outside  of  the  arch,  and  a  studded  band 
was  cemented  to  the  cuspid  with  the  stud  on  the  outside  of  the 
arch  also.  A  square  T  socket  No.  27  was  screwed  on  the  stud 
of  the  cuspid  Ixmd  and  a  T  Ijar  No.  19  was  cut  to  the  proper 

Fig.  35. 


Fig.  36. 


(Nos.  5,  27,  19,  22,  22,  8.) 

length,  and  the  T  end  of  the  T  bar  was  bent  so  that  when  the  T 
was  in  the  sc^uare  T  socket,  the  threaded  portion  of  the  bar 
would  be  in  the  proper  direction  to  enter  the  clutch  tube. 
This  was  easily  done  by  holding  the  T  in  a  pair  of  smooth  flat- 
nose  pliers  and  the  threaded  portion  in  the  fingers,  and  bend- 
ing the  T  neck  a  little  at  a  time  and  trying  it  in  the  T  socket 
every  time.     The  proper  angle  of  the  T  portion  may  be  found 


TEETH    REGULATION.  3 I 

in  a  few  minutes,  as  the  screw  portion  can  be  easily  slipped  in 
and  out  of  the  slot  in  the  clutch  tube. 

After  the  cuspid  had  been  drawn  back  so  as  to  nearly  touch 
the  second  bicuspid,  the  T  bar  and  socket  were  taken  off.  A 
piece  of  band  wire  Xo.  30  was  wound  around  the  stud  of  the 
band  on  the  cuspid  tooth  and  tied  to  the  clutch  tube  of  the 
clutch  band  on  the  molar,  to  hold  the  cuspid  in  position  while 
the  other  teeth  were  being  moved.      (Seen  in  Fig.  37.) 

The  second  part  of  the  operation  appears  in  Fig.  37.  A 
clutch  band  was  cemented  to  the  upper  right  first  molar  and 
a  studded  band  fixed  on  the  lateral.     Bite  bands  No.  15  were 

Fig.  zi- 


F 

(Nos.  S,  28,  20,  23,  25,  21,  24,  3, — 5,  30,  S.) 

attached  to  the  lower  right  first  bicuspid  and  the  lower  left 
second  bicuspid  (see  description  of  bite  bands),  and  the  patient 
was  dismissed  until  the  following  day  to  give  the  cement  and 
amalgam  a  good  chance  to  harden.  A  jack-screw  (Nos.  21. 
24,  25,  28,  20,  22,  23)  was  then  attached,  in  the  usual  manner, 
from  the  molar  to  the  lateral  and  pressure  applied. 

Note  the  location  of  the  stud  just  oti  the  center  of  the  lateral 
(magnified  cut  to  evidence  the  fact),  so  that  by  not  quite 
tightening  the  ball  cap  the  push  pressure  will  partially  rotate, 
while  moving  outward  the  lateral. 

After  the  lateral  had  moved  far  enough  to  be  outside  the 
lower  teeth,  the  bite  bands  were  taken  off,  and  three  days  after- 
ward the  jack-screw  was  also  taken  oft'.     No  retaining  appli- 


32  KNAPP    SYSTEM. 

ance  was  required  for  this  tooth,  as  the  articulation  with  the 
lower  teeth  prevented  it  from  moving  inward.  As  there  was 
no  further  use  for  the  bands  on  the  lateral  and  right  molar, 
these  were  also  removed. 

The  third  part  of  the  operation  is  illustrated  in  Fig.  38. 
A  studded  l)and  was  cemented  to  the  left  central.  The  clutch 
band  on  the  upper  left  molar  taken  off,  turned  over  and  fixed 
so  that  the  clutch  tube  would  be  on  the  inside  of  the  arch. 
The  jack-screw  having  a  short  right  and  left  threaded  nut  No. 
26  put  in  place  of  the  long  one  No.  25,  was  then  attached  to 
the  clutch  tube  of  the  left  molar  band  and  the  ball  cap  attached 
to  the  stud  on  the  band  on  the  central.      The  ball  cap  should 

Fig.  38. 


(Nos.  4,  24,  21,  26,  23,  2::>,  2S,  .S,  30,  5,) 

not  be  screwed  tight  against  the  ball,  as  this  would  prevent  the 
tooth  from  rotating,  but  should  be  left  loose  enough  to  give  the 
ball  free  movement.  It  will  be  seen  that  the  central  and  lateral 
were  both  being  drawn  back  toward  the  cuspid. 

As  soon  as  the  left  central  was  drawn  back  so  far  as  not  to 
overlap  the  right  central,  it  began  to  rotate;  and  the  traction 
was  continued  until  the  central  had  rotated  enough  to  be  in 
line  with  the  other  teeth,  when  the  regulation  was  completed. 

The  bands  were  then  taken  ofif  all  the  teeth  except  the  left 
central  (see  Fig.  39),  and  a  retaining  clamp  No.  37  with  nut 
No.  38  was  attached  to  the  stud,  leaving  the  ends  of  the  retain- 
ing clamp  resting  on  the  right  central  and  left  lateral,  thus  pre- 
venting the  left  central  from  rotating  and  the  lateral   from 


TEETH    REGULATION. 


33 


moving  inward.     The  cuspid  was  expected  to  naturally  move 
forward  and  fill  the  little  remaining  space,  which  it  did. 

The  case  was  left  for  six  months  with  the  retaining  clamp 
in  position,  as  shown  in  Fig.  39. 

Fig.  39. 


(Nos.  5,  37,  38.)  , 

A  common  occurrence  attending  the  eruption  of  the  per- 
manent teeth  is  illustrated  in  Fig.  40.  The  roots  of  the  upper 
deciduous  incisors  were  not  properly  absorbed,  causing  the 
permanent  teeth  to  erupt  inside  the  arch. 

Fig.  40. 


When  the  case  presented  itself  the  temporary  teeth  had 
been  extracted,  leaving  the  two  upper  central  incisors  firmly 
inlocked,  and  it  was  certain  that  the  teeth  must  be  forced 
outside  the  lower  arch  by  the  use  of  appliances,  as  the  case 
had  been  neglected  too  long  for  self  regulation. 

It  was  impossible  for  the  boy  to  draw  the  lower  jaw  back 
so  that  the  lower  centrals  would  touch  the  cutting  edges  of 
the  inlocked  upper  centrals,  and  the  wedging  together  of  the 
teeth  had  started  the  lower  teeth  outward.     As  the  time  that 


34 


KNAPP    SYSTEM. 


could  be  spent  in  correcting  the  irregularity  was  extremely 
limited,  and  the  parents  were  very  anxious  to  have  the  case 
attended  to  at  once,  studded  bands  were  immediately 
cemented  to  each  of  the  inlocked  centrals,  and  clutch  bands  to 
the  first  permanent  molars  with  the  clutch  tubes  on  the  inside 
of  the  arch.  The  next  morning  a  T  socket  clutch  bar  No.  28 
was  placed  in  each  of  the  clutch  tubes,  and  jack-screws  (Nos. 
20,  23,  25,  21,  24)  attached  from  them  to  each  of  the  studs  of 
the  bands  on  the  inlocked  centrals,  as  shown  in  Fig.  41. 

Fig.  41. 


(Nos.  8,  28,  20,  23,  25,  21,  24   4, — 5,  24,  21,  25,  23,  2c,  28,  8.) 

Observe  in  this  case,  also,  the  advantages  of  thoughtfully 
locating  the  studs  so  that  by  regulating  the  looseness  or  tight- 
ness of  the  ball  caps,  and  the  use  of  curved  neck  ball  bar  21, 
or  straight  neck  ball  bar  33,  either  complex  or  direct  move- 
ments may  be  effected  by  jack-screw  action. 

The  long  nuts  of  the  jack-screws  were  tightened  each  morn- 
ing and  evening,  until  a  snug  pressure  was  felt  by  the  patient, 
and  at  the  end  of  five  days  from  the  time  the  bands  were 
cemented  on  the  teeth,  they  were  both  in  their  proper  posi- 
tions. The  appliances  and  bands  were  then  removed,  and  the 
two  studded  bands  cemented  on  the  centrals  again  with  the 
studs  to  which  was  to  be  attached  the  retaining  appliance  Nos. 
39,  38,  on  the  outside  of  the  arch. 

In  the  case  illustrated  in  Fig.  42  all  of  the  six  upper  anterior 
teeth  were  out  of  their  proper  positions.  The  incisors  and 
laterals  were  too  far  inward,  the  lower  teeth  striking  on  the 


TEETH    REGULATION. 


35 


tips  of  the  upper  central  incisors.  Both  cuspids  were  a  Httle 
outside  the  proper  line  of  the  arch.  It  was  necessary  to  push 
the  centrals  and  laterals  forward  and  outward  and  draw  the 
cuspids  inward.  This  case  could  be  regulated,  with  the  de- 
vices on  hand,  in  two  or  three  ways,  but  it  was  deemed  ad- 
visable to  move  each  side  separately.  The  three  teeth  on 
the  right  side  were  moved  first. 


(Nos.  8,  28,  20,  32,  23,  25,  21,  24,  3,-5,  24,  21 ,  25,  23,  20,-5,  24,  21,  25,  23,  20.) 

A  clutch  band  was  cemented  to  the  upper  left  first  molar, 
and  studded  bands  to  the  right  central,  lateral,  and  cuspid. 
A  T  socket  clutch  bar  No.  28  was  placed  in  tlie  clutch  tube  of 
the  molar  band  to  which  were  attached  the  three  jack-screws 
as  shown  in  the  cut,  a  double  auxiliary  T  socket  No.  32  (see 
magnified  cut  in  brackets)  being  first  placed  on  the  T  bar  of 
the  central  jack-screw.     The  T  ends  of  the  T  bars  of  the  two 

No.  32. 


outer  jack-screws  were  slightly  bent,  as  shown  in  the  cut,  so 
as  to  leave  a  little  space  between  them  to  allow  the  nuts  to  be 
easily  turned.  The  jack-screw  which  was  to  be  attached  to 
the  lateral  was  placed  in  position  first,  the  one  belonging  to 
the  central  next,  and  the  one  reaching  to  the  cuspid  last. 

Pressure  was  applied  to  the  cuspid  and  lateral  in  the  direc- 


36  KNAPP    SYSTEM. 

tions  indicated  by  the  arrows.  The  jack-screw  attached  to 
the  central  was  first  turned  so  as  to  push  the  tooth  outward, 
and  the  wedging  of  the  lateral  moved  the  central  in  the  direc- 
tion indicated  by  the  arrow  at  A.  After  the  central  had  moved 
far  enough  outward,  the  tightening  of  this  jack-screw  was 
stopped  and  the  action  of  the  jack-screws  attached  to  the 
lateral  and  cuspid  continued,  which  reversed  the  action  of  the 
one  attached  to  the  central  that  served  to  hold  the  tooth  from 
moving  farther  outward,  its  action  being  as  indicated  by  the 
arrow  at  the  side  of  the  long  nut.  The  central  continued  to 
move  forward  as  indicated  by  the  arrow  at  A  until  the  lateral 
and  cuspid  were  in  their  proper  positions.     When  these  three 

Fig.  43. 


(Nos.  5,5.39.  38.38.) 

teeth  had  gained  their  proper  places,  the  jack-screws,  molar 
band,  and  band  on  the  lateral  were  removed,  and  a  piece  of 
retaining  band  No.  39  was  bent  to  conform  to  the  inner  sur- 
faces of  the  teeth,  and  holes  punched  in  it  for  the  studs  on 
the  central  and  cuspid  to  pass  through.  The  retainer  was 
then  placed  in  position  and  held  by  two  retaining  nuts,  No.  38, 
as  shown  in  Fig.  43. 

Bands  were  then  cemented  to  the  three  upper  left  anterior 
teeth,  and  the  clutch  band  to  the  right  molar,  and  the  jack- 
screws  attached  as  before  described  and  shown  in  Fig.  42. 

When  these  teeth  were  also  in  position,  the  jack-screws  and 
bands  to  which  they  were  attached  were  removed,  excepting 
the  studded  band  on  the  cuspid.  This  was  left  on  for  the 
attachment  of  the  retaining  band.  No.  39. 

The  band  that  had  been  placed  in  position  to  retain  the  three 


TEETH    REGULATION.  37 

teeth  of  the  right  side  was  taken  off,  and  a  new  band  fitted  that 
would  be  long  enough  to  reach  from  the  first  bicuspid  of  one 
side  around  the  inside  of  the  six  anterior  teeth  to  the  first 
bicuspid  of  the  other  side. 

The  retaining  band  was  first  bent  to  nearly  conform  to  the 
shape  of  the  arch.  It  was  then  cut  narrower  with  a  pair  of 
plate  nippers,  as  shown  in  Fig.  44,  spaces  the  full  width  of 

Fig.  44. 


the  band  being  left  at  the  points  of  contact  of  the  two  cuspids 
and  the  right  central. 

After  being  cut  to  nearly  the  proper  shape,  the  band  was 
bent  to  accurately  conform  to  the  teeth  and  holes  punched  to 
receive  the  three  studs  of  the  bands  left  on  the  teeth.  The 
retainer  was  then  filed  smooth  and  placed  in  position,  and 
three  retaining  nuts  No.  38  screwed  on  the  studs  of  the  three 
bands  as  shown  in  Fig.  45,  which  retainer  held  the  teeth  firmly 
in  position.     This  was  left  in  place  a  little  over  six  months. 

Fig.  45. 


(Nos.  5,  5,5,  39,  38,38,  38.) 

A  case  such  as  is  commonly  met  with,  although  generally 
not  irregular  in  such  a  marked  degree,  is  illustrated  in  Fig.  46. 
In  this  case  the  right  lateral  was  in  such  close  relation  to  the 
first  bicuspid  that  it  was  difficult  to  get  a  thread  between  them, 
and  all  the  superior  anterior  teeth  were  inside  the  lower  teeth, 
giving  the  upper  lip  a  sunken,  and  the  lower  lip  a  very  promi- 
nent appearance.  The  center  of  the  face,  lips,  and  lower  teeth 
Vv'as  about  in  the  center  of  the  upper  left  central,  thus  giving 


38 


KNAPP    SYSTEM. 


the  mouth  a  one-sided  appearance  when  the  lips  were  opened. 
When  the  case  presented  itself  the  tip  of  the  upper  right 
cuspid  was  just  appearing  through  the  gum  at  some  distance 
above  the  other  teeth.     It  was  necessary  to  move  the  five 

Fig.  46. 


anterior  teeth  outward  out  of  inlock  and  also  to  force  them  all 
to  the  left  far  enough  to  admit  of  the  right  cuspir'.  being  placed 
in  the  arch. 

The  upper  left  first  molar  (A)  was  very  badly  decayed,  and 
was  the  only  carious  tooth  in  the  mouth.  That  was  extracted, 
and  an  apparatus  put  on  for  moving  the  teeth  as  shown  in 

Fig.  47- 

Fig.  47. 


(Nos.  8,  3,  5,  8,  39,  27,  27,  19,  22, -22,  19,  22,  22.) 


Clutch  bands  were  cemented  to  the  right  first  molar  and  the 
left  second  molar,  and  studded  bands  to  the  right  lateral  and 
the  left  cuspid.     A  piece  of  retaining  band  No.  39  was  bent 


TEETH    REGULATION. 


39 


to  conform  to  the  inner  surfaces  of  the  anterior  teeth,  and  holes 
punched  for  the  studs  of  the  bands  on  the  lateral  and  the 
cuspid  to  pass  through.  The  retaining  band  being  thus  ex- 
tended from  the  lateral  to  the  cuspid,  prevented  the  front 
teeth  from  becoming  twisted  or  rotated  and  overlapping  each 
other  when  pressure  was  applied  as  indicated  by  the  arrows 
to  force  them  outward  and  sidewise  to  the  left  through  the 
alveolar  process. 

Square  T  sockets  No.  27  were  screwed  on  each  of  the 
studs,  and  a  T  bar  (the  square  corners  of  the  T  heads  being 
first  filed  off  so  that  they  could  rotate  in  the  square  T  sock- 
ets) placed  from  each  of  the  square  T  sockets  to  the  clutch 


(Xos.  S,  2S,  20,  32,  23,  25,  21,  24,  5,-3,  24,  21,  25,  23,  20,-6,  24,21,  25,  23,  20.) 


bands,  pressure  being  applied  to  efTect  movement  as  incHcated 
by  the  arrows.  Bite  bands  were  placed  on  each  of  the  lower 
first  bicuspid  teeth,  and  as  soon  as  the  upper  teeth  had  moved 
forward  sui^ciently  to  strike  sc[uarely  on  the  lower  incisor 
teeth,  these  bite  bands  were  taken  off. 

Both  T  bars  were  regularly  tightened  a  little  at  a  time  (the 
T  bar  on  the  right  side  being  turned  more  each  time  than  the 
one  on  the  left)  for  about  three  months,  when  the  teeth  had 
gained  the  position  shown  in  Fig.  48.  The  five  anterior  teeth 
were  then  striking  outside  the  lower  teeth,  the  interdental 
space  between  the  central  incisors  being  on  the  median  line 
and  the  left  second  bicuspid  touching  the  second  molar. 


40  KNAPP    SYSTEM. 

A  retaining  appliance  was  then  put  on  as  shown  in  Fig.  49. 
This  was  left  in  position  six  months  to  allow  the  teeth  to 
become  fixed  in  their  new  positions,  and  also  to  allow  the 
cuspid  time  to  become  fully  erupted,  after  which  the  triple 
jack-screw  a]:)i:)liance  (the  same  one  used  in  Fig.  42)  was  put 
on  and  the  cuspid  drawn  into  place  as  shown  in  Fig.  48. 

The  jack-screws  and  bands  were  then  all  taken  off  except- 
ing the  bands  on  the  cuspid  and  first  bicuspid,  to  which  was 
attached   the    retaining   appliance    in    the    manner   shown   in 

Fig.  50- 

Fig.  49. 


(Nos,  6,  3,  39,38,38.) 

Fig.  50. 


(Nos.  5,  37,  38.) 

SADDLE-SHAPED  ARCHES. 

Of  all  the  cases  of  irregularities  of  the  teeth  that  present 
themselves  for  treatment,  probably  none  exhibit  such  a 
marked  similarity  as  those  with  constricted  or  saddle-shaped 
arches. 

Fig.  51  shows  a  typical  case,  and  the  devices  there  illus- 
trated will  quickly  and  effectually  accomplish  the  desired  end 
with  almost  no  alteration  from  the  combination  of  parts 
shown  in  the  illustration,  which  shows  a  completed  case. 

In  these  cases  clutch  bands  are  fixed  onto  the  molar  teeth, 
one  on  each  side,  and  single  socket  clutch  bands  to  the  first 
bicuspid  of  each  side.  Single  auxiliary  T  sockets  No.  31  are 
placed  in  the  center  of  each  of  two  T  bars,  and  the  T  bars 


TEETH    REGULATION. 


41 


organized  as  follows  to  be  placed  in  position  one  on  each  side 
of  the  arch  as  shown  in  the  cut. 

A  short  T  bar  No.  20.  on  which  has  been  placed  a  lock  nut 
No.  2T^,  is  cut  to  the  proper  length  and  screwed  into  the  right- 
hand  end  of  a  short  right  and  left  threaded  nut  No.  26.  Into 
the  other  end  is  screwed  a  left-hand  threaded  T  bar  No.  40. 
The  T  ends  are  then  placed  one  in  each  of  the  single  auxiliary 
T  sockets,  and  this  organization  will  then  admit  of  the  two  T 
bars  being  adjustably  placed  in  the  clutch  tubes  as  seen  in 

Fig-  51- 

Fig.  51. 


(Nos.  20,  23,  26,  40,-19,  31,  22,  22,-19,  o'l  22,  22,-46,  46,  50,  50.) 


It  will  be  seen  that  the  pressure  may  be  applied  at  any 
point  on  the  T  bars  forward,  backward,  or  diagonally  in  the 
mouth.  And  the  points  of  force  (the  positions  the  T  sockets 
occupy  on  the  T  bars)  may  be  changed  without  removing  any 
part  of  the  appliance,  by  simply  loosening  the  clutch  nuts  and 
revolving  the  T  bars  with  a  pair  of  small  pliers  applied  to  the 
T  heads.  This  will  cause  the  T  socket  to  travel  along  the 
T  bar,  and  it  may  be  placed  at  any  point  in  this  manner,  and 
when  the  clutch  nuts  are  again  tightened  on  the  clutch  tube, 
the  T  bar  is  prevented  from  revolving,  and  the  T  sockets  are 
prevented  from  moving. 

As  this  device  is  very  powerful,  care  should  be  taken  not  to 


42  KNAPP    SYSTEM. 

tighten  the  right  and  left  threaded  nut  too  much  at  a  time,  or 
the  superior  maxillary  bones  may  be  separated.  If  this  should 
happen,  it  is  easily  detected,  as  a  wider  space  than  usual  will 
appear  between  the  central  incisor  teeth,  when  of  course  the 
tightening  should  be  discontinued  for  a  few  days. 

To  retain  the  teeth  in  these  cases  it  is  best  to  vulcanize  a  thin 
rubber  plate  to  cover  as  little  of  the  roof  of  the  mouth  as  pos- 
sible and  still  be  large  enough  to  rest  against  all  the  teeth  that 
have  been  moved. 

In  the  case  illustrated  by  Fig.  52,  the  upper  cuspids  were 
both  outside  the  arch,  and  the  centrals  and  laterals  formed 
one-half  of  a  circle  the  diameter  of  which  was  less  than  an 

Fig.  52. 


inch.  Each  lateral  striking  between  the  lower  cuspids  and 
the  laterals  caused  the  lower  laterals  to  be  quite  a  distance 
inside  the  lower  line  of  the  arch. 

The  eight  incisor  teeth  of  both  jaws  were  not  prominent 
enough  to  give  the  proper  expression  to  the  lips,  and  it  was 
necessary  to  force  these  eight  teeth  outward  and  draw  the 
superior  cuspids  into  the  arch  to  give  the  lips  their  proper 
expression. 

An  appliance  was  first  placed  on  the  upper  teeth  to  force  the 
four  anterior  teeth  outward,  as  .'^hown  in  Fig.  53. 

Clutch  bands  No.  8  were  cemented  to  each  of  the  upper 
first  molars,  and  studded  bands  No.  3  likewise  fixed  upon  the 
laterals. 

A  piece  of  retaining  band  No.  39  was  bent  to  fit  the  inner 


TEETH    REGULATION. 


43 


surfaces  of  the  four  anterior  teeth,  and  holes  punched  to  re- 
ceive the  studs  of  the  bands  on  the  laterals.  T  socket  clutch 
bars  No.  28  were  then  placed  in  each  of  the  clutch  tubes  of 
the  molar  bands,  to  which  were  attached  the  jack-screws 
(Nos.  20,  23,  26,  21,  and  24).  The  ball  caps  No.  24  when 
screwed  on  to  the  studs  of  the  bands  on  the  laterals  held  the 
retaining  band  in  position.  The  arrows  indicate  the  direction 
of  the  applied  pressure  which  moved  the  four  front  teeth  out- 
ward, the  retaining  band  preventing  them  from  crowding 
together  and  becoming  uneven  during  this  operation. 

Ftg.  53. 


(Nos.  3,  3,  39.— S,  28,  20,  23,  26,  21,  24.-24,  21,  26,  23,  20,  28,  8.) 

When  these  teeth  had  been  moved  far  enough  outward,  the 
cuspids  were  one  after  the  other  drawn  into  the  arch  with  the 
combination  shown  in  Fig.  48. 

The  lower  laterals  were  forced  outward  and  the  arch  ex- 
panded to  receive  them  by  the  use  of  the  threaded  arch  bar 
No.  35,  as  shown  in  Fig.  54.     (See  Fig.  58.) 

Clutch  bands  No.  8  were  cemented  to  each  of  the  lower 
first  molars,  and  single  socket  clutch  bands  No.  1 1  likewise 
fixed  upon  the  laterals.  Four  clutch  nuts  No.  22  were  placed 
with  their  rounded  portions  toward  each  other  (as  in  Fig. 
58)  on  the  arch  bar  No.  35,  and  the  bar  bent  and  cut  to  the 
proper  length. 

Bar  end  caps  No.  34  were  then  screwed  on  the  ends  to  pre- 


44 


KNAPP    SYSTEM. 


vent  irritation  of  the  tongue.  The  center  portion  of  the  bar 
that  would  come  inside  the  six  anterior  teeth  was  bent  to  the 
proper  shape  that  the  teeth  should  be  in  when  the  case  should 
be  completed  and  the  bar  placed  in  position.  Pressure  was 
applied  as  indicated  by  the  arrows. 

The  laterals  w'cre  first  forced  forward,  and  pushed  the  cen- 
trals ahead  of  them.  The  cuspids  were  also  forced  apart, 
giving  room  for  the  laterals  in  the  arch. 

When  the  laterals  and  centrals  had  been  forced  outward  far 

Fig.  5-1. 


(NOS.  8,  II,   II,  8,-35,  22,  22,  34,-22,  22,  34. 

Fig.  55. 


(Nos.  3,3,  39,  38,38.) 

enough,  the  arch  bar  and  bands  were  removed,  and  studded 
bands  No.  3  placed  on  the  laterals,  with  the  studs  outside  the 
arch,  to  which  studs  was  attached  the  retaining  band  No.  39 
(see  description  of  Fig.  44).  The  band  was  held  in  position 
by  two  retaining  clamp  nuts  No.  38,  as  shown  in  Fig.  55. 

It  is  noteworthy  that  by  suitably  bending  one  of  these  re- 
taining bands  to  bear  properly  on  the  surface  of  a  tooth  situ- 
ated between  the  studs,  or  beyond  a  stud,  regulating  pressure 
may  be  applied  by  turning  the  nut  No.  38,  or  the  series  of 
nuts,  as  the  case  may  be,  whether  the  band  be  located  labially 
as  seen  in  Fig.  55,  or  lingually  as  shown  in  Fig.  45. 


TEETH    REGULATION. 


45 


RETAINING  DEVICES. 

The  parts  numbered  37,  38,  and  39  are  used  for  holding  the 
teeth  in  line  after  they  have  been  moved  to  their  proper  posi- 
tions. 

The  retaining  clamp  No.  2i7  is  attached  to  the  bands  by 
passing  the  stud  of  the  band  through  the  hole  in  the  broadened 
center  of  the  clamp,  the  ends  of  the  clamp  being  first  suitably 
bent  to  rest  upon  the  adjoining  teeth.  A  retaining  nut  No. 
38  (magnified  cut  in  brackets)  is  then  screwed  on  the  stud  of 
the  band  which  holds  the  clamp  in  position. 

Part  No.  39  is  a  blank  band  which  is  to  be  prepared  to  con- 
nect a  number  of  teeth  when  thev  are  all  to  be  moved  in  one 


No.  37. 


No.  38. 


No.  39. 


Fig.  56. 
0  C 


direction,  and  also  is  to  be  made  as  a  retainer  when  a  number 
of  teeth  are  to  be  held  in  line,  -making  it  necessary  to  place 
bands  on  two  or  more  teeth. 

To  attach  a  retaining  or  a  connecting  band  No.  39  to  the 
teeth: 

First  make  a  pattern  of  sheet  tin,  or  lead,  punching  holes 
in  the  pattern  for  the  studs  of  the  bands  to  pass  through. 
This  will  mark  the  proper  distances  apart  that  the  holes  should 
be  punched  in  the  retaining  band.  After  bending  the  band  to 
the  proper  curve  the  holes  should  be  punched,  the  band  placed 
in  position,  and  a  retaining  nut  No.  38  screwed  on  each  of  the 
studs  which  pass  through  the  band  to  hold  it  in  position. 

Fig.  56  represents  at  A  a  hole  punched  to  receive  the  stud 
of  the  band  on  the  tooth.  B  indicates  a  slot  formed  by  punch- 
ing a  succession  of  holes.  This  may  be  necessary  in  some 
cases,  especially  when  the  holes  have  not  been  properly 
punched  at  first. 


46 


KNAPP    SYSTEM, 


When  it  becomes  necessary  to  bend  the  band  in  the  plane 
of  its  width,  cut  a  V-shaped  notch  two-thirds  the  width  of  the 
band  as  shown  at  C,  Fig,  56.  This  will  allow  the  band  to  be 
bent  in  a  lateral  direction. 

If  it  should  be  advisable  to  have  the  band  as  narrow  as  pos- 
sible it  may  be  so  made  as  shown  at  D,  Fig.  56,  by  cutting 
away  two-thirds  of  the  width  of  the  band  with  plate  nippers 
and  filing  off  the  points  smooth  with  a  half-round  file  as  shown 
at  E.  Carefully  leave  enough  metal  to  surround  the  stud  at 
the  parts  of  the  band  where  the  holes  are  punched  to  receive 

the  studs. 

Fig.  57. 


When  the  preliminary  pattern  for  a  retainer  or  connector 
has  been  formed,  the  holes  in  the  blank  band  No.  38  may  be 
first  punched  with  a  plate  punch,  and  then  enlarged  with  an 
engine  bur.  The  round  bur  No,  6  or  the  bud  bur  No.  52  will 
cut  suitably  sized  holes  to  allow  the  studs  on  the  bands  to 
pass  through  the  retainer  to  receive  the  No,  38  retaining  nuts. 

An  example  of  a  retaining  band  is  seen  in  Fig.  57. 

Fig.  58. 


THE  THREADED  ARCH  BAR. 

The  several  styles  of  studded  and  clutch  bands  readily  lend 
themselves  to  the  well-known  uses  of  the  threaded  arch  bar 
No.  35,  which,  when  provided  with  the  clutch  nuts  No.  22  dis- 


TEETH    REGULATION.  47 

posed  as  shown  in  Fig.  58,  may  be  quickly  placed  in  or  taken 
from  the  clutch  tubes  of  the  bands,  when  these  are  fixed  on  the 
molars  or  bicuspids  of  both  sides.  Observe  in  Fig.  58  the  rela- 
tions of  the  clutch  nuts  Nos.  22,  22  to  22',  22',  as  that  disposal 
of  them,  with  the  rounded  portions  toward  each  other,  adapts 
them  to  the  locking  sockets  of  the  clutch  tubes,  as  previously 
explained. 

When  the  threaded  arch  bar,  or  T  bar,  is  to  be  bent,  slip 
sections  of  a  small  rubber  tube  over  the  plier  jaws  to  prevent 
injury  to  the  screw  threads.  Better  still,  take  a  piece  of  hard 
wood  or  bone  of  about  two  inches  long,  half  an  inch  wide,  and 
a  quarter  of  an  inch  thick;  put  a  fissure  bur  No.  70  in  the 
engine  hand-piece,  hold  it  at  a  right  angle  to  the  wood  edge, 
and  cut  a  slot  about  an  eighth  of  an  inch  deep.  While  the 
bur  is  at  the  bottom  of  the  slot,  swing  the  hand-piece  slightly 
back  and  forth  lengthwise  of  the  wood  to  round  the  inner 
corners  of  the  slot.  The  bar  may  then  be  slid  into  the  slot  and 
be  bent,  or  straightened,  without  injury  to  the  threads  over 
which  the  nuts  are  to  pass.  By  thinning  one  edge  of  the  wood, 
a  slot  in  it  can  be  adapted  to  the  bending  of  short  curves,  when 
these  are  requisite  in  conforming  the  bar  to  the  case  in  hand. 

Indeed,  it  seems  advisable  to  here  renewedly  emphasize 
the  fact  that  these  appliances  are  in  character  like  in- 
struments of  precision,  and  are  designed  for  thoughtful  and 
skillful  professional  uses  in  the  correction  of  dental  deformities 
and  irregularities.  Therefore  the  several  members  are  finely 
finished  and  delicate  in  dimensions,  yet  are  sufficiently  strong 
for  proper  employment  in  moving  living  organs  set  in  yielding 
tissues;  the  pressure  should  always  be  simply  sufficient,  with- 
out being  excessive. 

The  several  parts  are  formed  with  exactness,  and  are  accu- 
rately gauged  by  the  inspector  to  be  as  sure  as  is  practicable 
that  every  part  will  fit  its  related  part.  For  instance,  the  T  end 
of  the  T  bars,  Nos.  19,  20,  and  40,  will  easily  enter  the  slot  of 
the  square  T  socket  No.  27  at  a  right  angle  to  the  socket  or 


48  KNAPP    SYSTEM. 

mortise;  and  the  l)ar  is  tlien  to  1)e  swung  to  the  right  or  left, 
while  the  T  end  is  pushed  against  the  socket  wall  opposite  the 
slot  until  the  bar  is  swung  in  line  with  the  squared  socket,  which 
the  square  T  will  then  enter  by  push,  or  jmll,  and  closely  fit 
and  be  squarely  secured  for  its  carefully  designed  uses.  (See 
Fig.  17.)  A  like  process  is  to  be  pursued  when  placing  a  T 
bar  in  the  round  T  sockets  of  Nos.  28,  31,  and  32;  Init  in  these 
the  T  is  secured  so  soon  as  the  bar  is  swung  to  the  right  or  left 
of  the  slot;  yet  the  pull  or  push  action  may  be  employed  at  any 
radius  from  the  socket  within  the  swinging  range  of  the  bar. 
But,  as  in  the  previous  instance,  the  insertion  of  the  T  is  to  be 
carefully,  yet  easily,  effected  without  undue  force,  because  if  it 
does  not  readily  enter  through  the  slot  and  get  seated  in  the 
socket,  a  thoughtful  readjustment  of  the  socket  or  other  parts 
is  necessary.  Then,  too,  in  turning  the  ball  cap  of  the  ball  bar 
upon  the  stud  of  the  band  in  the  jack-screw  organization,  as 
shown  in  Fig.  14,  careful  delicacy  of  manipulation  with  judg- 
ment is  requisite  in  starting  the  threads  of  the  cap  right  over 
the  threads  of  the  stud,  to  avoid  wrenching  them  ruinously,  and 
needlessly,  since  the  ball  and  socket  joint  provides  for  the 
proper  engagement  of  the  stud  with  the  screw  cap. 

Recurring  to  Fig.  58,  it  is  to  be  furthermore  said  that  the 
arch  bar  is  threaded  along  its  entire  length,  and  thus  provides 
for  the  familiar  ligature  process  of  regulation,  as  the  screw 
threads  permit  the  non-slipping  fastening  of  the  ligatures  to  the 
bar  at  any  angle  of  draft  on  the  teeth  to  be  drawn  directly  or 
obliquely  outward. 

In  cases  requiring  inward  movement  of  the  oral  teeth,  single 
socket  clutch  bands  may  be  fixed  showing  the  clutch  tubes  on 
the  labial  aspects  of  the  teeth.  The  arch  bar,  as  shown  in  Fig. 
58,  may  then  be  seated  in  clutch  tubes  fixed  on  the  second 
molars,  and  the  suitably  bent  bow  of  the  bar  be  made  to  rest 
in  the  clutch  tubes  of  the  bands  on  the  anterior  teeth.  A  trac- 
tive stress  may  then  be  initiated  by  loosening  nuts  22',  22' 
and  tightening  nuts  22,  22,  Fig.  58.  Two  bar-end  caps  No. 
34  screwed  on  the  ends  of  the  bar  will  protect  the  cheek  and 


TEETH    REGULATION.  49 

tongue  from  irritation.  The  organization  thus  appHed  will 
prove  effective  and  satisfactory.  Other  similar  combinations 
may  be  readily  arranged  and  applied  to  meet  presenting  cases. 

The  nuts  on  all  the  bars  work  easily,  so  that  before  and  after 
using  the  wrench  they  may  usually  l^e  turned  on  the  bars  into 
or  out  of  position  by  sweeping  over  them  with  the  ball  of  the 
finger. 

With,  reference  to  the  screw  band  it  is  to  be  said  that  care 
should  be  taken  not  to  tighten  the  nut  too  tight,  as  more  bands 
are  broken  from  this  cause  than  from  actual  use.  After  the 
band  has  been  placed  on  the  tooth  in  the  required  position,  the 
nut  should  be  turned  moderately  tight  $ind  the  band  burnished 
to  conform  to  the  irregularities  of  the  tooth's  surface.  The 
nut  can  then  be  turned  somewhat  tighter  to  take  up  the  slack 
caused  by  burnishing. 

The  nut  need  only  be  turned  tight  enough  to  prevent  the 
band  being  pulled  from  the  tooth  with  the  lingers.  After  the 
nut  has  been  sufficiently  tightened  to  cause  the  band  to  be  in 
contact  with  the  tooth's  surface  at  all  points,  further  tightening 
only  injures  the  band,  as  the  band  wall  not  stretch  and  the  tooth 
cannot  be  compressed.  Do  not  kink  the  band  or  attempt  to 
drive  it  into  position  by  the  use  of  a  mallet,  plugger  or  other 
steel  instrument.  Always  work  tlie  band  onto  the  tooth  with 
the  lingers,  as  the  nut  can  be  quickly  and  easily  slipped  off  the 
slotted  collar  and  the  band  straightened  out  when  necessary. 
The  working  of  the  bands  between  the  teeth  and  getting  the 
tubes  or  studs  in  their  proper  positions  is  thus  greatly  facili- 
tated. 

In  the  case  illustrated  in  Fig.  59  the  superior  right  cuspid 
was  to  be  pushed  into  line  from  the  anchorage  of  the  superior 
left  second  bicuspid,  which  was  somewhat  inside  the  line.  A 
studded  band  No.  5  was  cemented  on  the  cuspid,  a  single 
socket  band  No.  13  was  fixed  on  the  bicuspid,  the  socket  open- 
ing anteriorly,  while  a  screw  l)and  No.  49  was  placed  on  the 
first  molar.     A  clutch  bar  No.  28  had  a  lock-nut  No.  23  and 

4 


50 


KNAPP    SYSTEM. 


two  clutch  nuts  No.  22  put  on  it,  and  was  then  set  and  screw- 
locked  in  the  two  socket  clutches  of  the  bicuspid  and  molar  as 
shown  in  the  figure. 

A  No.  24,  21,  25,  20  jack-screw  (see  Fig-.  15)  was  duly  con- 
nected with  the  stud  of  the  cuspid  band,  as  also  with  the  round 
T-socket  of  the  No.  28  bar,  and  pushing  pressure  was  then 

Fig.  59. 


(Nos.  5,   13,  4q,  28,  23,  22,  22.  20,  25,  21,   24.) 

effected  in  the  direction  of  the  arrow.  Obviously,  the  bicuspid 
would  get  the  direct  anchorage-thrust  of  the  jack-screw,  and, 
while  receiving  some  support  from  the  coupled  molar,  would 
somewhat  yield  under  the  stress  requisite  to  move  the  stubborn 
cuspid  into  position;  the  bicuspid  also  getting  into  Hne. 

When  this  had  been  accomplished  the  jack-screw  was  re- 
moved, the  bar  No.  28  detached  from  the  bicuspid  band  socket, 
and  replaced  in  the  molar  band  socket.  A  studded  band  No.  3 
-was  fixed  on  the  lateral,  and  a  single  auxiliary  socket  No.  31 
was  screwed  on  the  bar  No.  20  between  its  T  and  the  end  of 
No.  25.  To  that  No.  31,  another  jack-screw,  was  coupled,  and 
the  T  of  the  first  jack-screw  placed  in  the  No.  28  of  the  molar 
band.  The  respective  ball  caps  of  the  two  jack-screws  could 
then  be  coupled  to  the  studs  on  the  cuspid  and  lateral  in  a 


TEETH    REGULATION.  5 1 

manner  similar  to  the  organization  shown  in  Fig.  22.  Then, 
while  the  cnspid  was  held  in  place  by  the  jack-screw  with  which 
it  w^as  first  pushed  into  position,  the  lateral  could  with  the 
other  jack-screw  be  pulled  into  line. 

It  will  sometimes  occur  that  the  malposed  cuspid  or  bicuspid 
of  a  full-grown  patient  is  unusually  resistant  to  tractive  action, 
and  in  such  a  case  reinforcing  aid  may  be  expedient. 

Fig.  Go. 


(Nos.   S,  5,  19,   22,   22,  27.) 

In  Fig.  60  is  seen  an  example  similar  to  that  of  Fig.  18.  In 
this  instance  a  section  of  a  rubber  tube.  A,  is  by  means  of  liga- 
tures stretched  between  the  band  buttons  of  the  molar  and  bi- 
cuspid. The  operative  traction  of  the  bar  No.  19  will  be  aided 
by  the  pull  of  A,  the  constant  drag  of  which  will  be  checked 
or  limited  by  the  intermittent  action  of  the  bar  controlled  by 
the  nuts  22,  22;  thus  avoiding  the  common  danger  of  over-pull 
by  the  gum  elastic  if  the  patient  should  delay  recourse  to  the 
dentist,  a  not  infrequent  event. 

In  this  case  the  cuspid.  Fig.  61,  is  being  retracted  by  a  T-bar 
organization  like  that  of  Fig.  30,  while  the  lateral  is  subject  to 
the  dragging  and  rotative  action  of  a  jack-screw,  the  right- 
hand  threaded  end  of  which  directly  engages  the  screw  of  a  No. 
49  band.  This  very  effective  combination  led  to  the  later 
adoption  of  the  T-bar  size  and  thread  for  all  the  screw  bands. 


0- 


KXAPP    SYSTEM. 


thus  providing"  for  other  like  organizations.  In  the  present 
case  it  may  be  seen,  that  if  24  is  not  turned  tight  on  tlie  ball  of 
21,  the  traction  will  rotate  as  well  as  retract  the  lateral. 


Fig.  61. 


(NOS.  49,  12,    3,    19,    2, 


34,  25,  24,  21.) 


Fig.  62  shows  a  case  in  which  the  upper  incisor  teeth  oc- 
cluded directly  on  or  a  little  back  of  the  cutting-edges  of  the 

lowTr  incisor  teeth. 

Fig.  62. 


(Nos.  50,  2S,    20,    23,    26,    21,    24,  3S     39,    3,    4  ) 

There  was  not  enough  room  for  the  upper  right  cuspid  in  the 
arch,  and  the  upper  incisors  all  stood  a  little  apart  from  each 
other  (not  shown  in  the  cut). 

The  left  cuspid  and  right  lateral  were  banded  with  studded 
bands,  and  the  right  first  molar  with  a  double-socket  screw 


TEETH    REGULATION. 


53 


band.  A  piece  of  retaining  and  connecting  band,  No.  39,  was 
punched  to  go  over  the  studs  of  the  bands  on  the  cuspid  and 
lateral,  and  was  trimmed  to  a  narrower  width  where  it  passed 
over  the  lingual  surfaces  of  the  centrals  and  left  lateral,  as 
shown  in  the  cut.  Then  a  round  T-socket  clutch  bar  No.  28 
was  placed  in  the  clutch  tube  of  the  band  on  the  molar,  and  a 
jack-screw  (composed  of  Nos.  20,  23,  26,  21,  and  24)  attached 
from  it  to  the  stud  of  the  band  on  the  lateral.  It  will  be  also 
noticed,  in  referring  to  the  cut.  that  this  band  is  held  to  the 
stud  of  the  band  on  the  cuspid  by  a  retaining  nut,  No.  38,  and 
to  the  stud  of  the  band  on  the  lateral  by  the  ball  cap  (No.  24) 
of  the  jack-screw. 

The  hole  for  the  stud  of  the  band  on  the  lateral  was  elon- 
gated with  a  fissure  bur  (see  cut)  so  as  to  allow  the  teeth  to 
crowd  together  until  the  spaces  between  them  had  been  closed. 
As  soon  as  the  teeth  were  in  contact  the  ball  cap  was  screwed 
tightly  against  the  band,  which  pre\'ented  any  more  crowding 
and  held  the  teeth  in  line  while  they  were  being  forced  forward 
to  their  proper  positions. 

The  wire  ligatures  seen  in  the  iHustration  were  not  employed 
in  the  present  case,  but  they  are  shown  as  applicable  in  some 
similar  cases  to  secure  the  bar  in  contact  with  the  lingual  sur- 
faces of  the  teeth.  The  author,  however,  prefers  the  employ- 
ment of  bands  wherever  applicable. 


Fig.  63. 


Fig.  64. 


In  Figs.  63  and  64  are  seen  the  lateral  aspects  of  a  peculiar 
form  of  saddle-shaped  arch.     Fig-.  63  shows  on  the  left  side  the 


54 


KNAPP    SYSTEM. 


occlusion  of  the  teeth  to  be  ahnost  normal.  Fig.  64  shows  the 
teeth  of  the  right  side,  which,  beginning  with  the  lateral,  are  all 
inside  the  arch.  In  this  case  a  modified  form  of  the  appliance 
shown  in  Fig.  51  is  used,  the  bicuspids  and  molars  of  the 
left  side  being  used  as  anchor  teeth,  and  only  one  tooth  of  the 
right  side  forced  out  at  a  time,  as  shown  at  Fig.  65.     It  will 

Fig.  65. 


(Nos.  42,  24,  33,  26,  20,  19,  22,  31,  22,  22,  49,  13,  46.) 

be  readily  seen  that  by  using  four  teeth  as  anchorage  to  move 
one,  all  of  the  inlocked  teeth  may  be  successively  moved  into 
position,  one  at  a  time,  without  moving  the  anchor  teeth  which 
are  already  in  their  proper  positions.  This  form  of  compound 
anchorage  may  be  used  in  any  case  where  jack-screws  are  ap- 
plicable, and  is  often  necessary  in  the  case  of  a  stubborn  cuspid, 
when  one  jack-screw  can  thus  be  used  to  force  the  tooth  into 
position. 

In  the  case  illustrated,  the  first  and  second  bicuspid  teeth, 
to  use  for  anchorage,  were  banded  with  single-socket  clutch 
bands  (either  screw  or  button),  and  the  second  molar  with  a 
double-socket  screw  band.  A  clutch  nut.  No.  22,  was  placed 
on  a  T  bar  19,  followed  by  a  single  auxiliary  T  socket  31,  and 
two  clutch  nuts,  22.  A  jack-screw,  composed  of  parts  num- 
bered 20,  26,  33,  and  24.  was  attached  from  the  single  auxiliary 


TEETH    REGULATION. 


55 


T  socket  to  the  stud  of  the  band  on  the  tooth  to  be  moved,  as 
shown  in  the  cut.  The  position  of  the  single  auxihary  T 
socket  on  the  T  bar  can  be  readily  changed  by  loosening  the 
clutch  nuts  and  revolving  the  bar.  The  socket  will  travel  for- 
ward or  backward  on  the  bar  as  the  bar  is  revolved  to  the  right 
or  left. 

SIMPLE  ROTATION. 

Fig.  66.  Fig.  67. 


(Nos.  3,  39,  38,  30.) 


(Nos.  3,  37,  38.) 


Fig.  68. 


(Nos.  3,  37,  38-) 


Spring  lever  rotation  of  a  single  tooth  is  illustrated  in  Fig. 
66.  In  this  typical  case  a  studded  band  No.  3  was  cemented 
on  the  upper  right  lateral.  With  the  retaining  band  punch  a 
hole  was  punched  in  one  end  of  a  piece  of  the  retaining  and  con- 
necting band  No.  39,  as  shown  at  A.  This  was  suitably  curved, 
and  with  No.  38  fixed  on  the  stud  of  the  band  of  the  lateral  in- 
cisor. This  bent  spring  lever  was  then  secured  to  the  second 
bicuspid  by  a  ligature  of  band  wire  No.  30.  Obviously,  suc- 
cessive slight  bendings  of  the  lever  from  day  to  day  will  exert 
a  rotative  action  upon  the  tooth  until  the  desired  relations  shall 
have  been  attained.  Then  the  retaining  clamp  No.  37  may  re- 
place the  lever  to  maintain  the  proper  position  of  the  tooth. 


5,6  KNAPP    SYSTEM. 

The  regulative  function  of  the  retaining  clamp  No.  37  is 
exemplifiecl  in  Fig.  dy,  where  it  is  shown  in  action  on  an  in- 
ward lateral  incisor.  This  had  fitted  and  cemented  upon  it  a 
studded  band  No.  3,  and  a  No.  37  was  bent  as  shown  at  B,  and 
a  retaining  nut  No.  38  screwed  onto  the  stud.  It  will  be  seen 
that  the  bow  of  the  clamp  does  not  quite  touch  the  band,  and 
consequently,  when  the  wings  rest  on  the  cuspid  and  central, 
a  turn  of  the  nut  will  pull  the  banded  lateral  outward.  When 
a  degree  of  movement  has  been  effected,  the  bends  of  the  bar, 
as  at  B,  are  lessened  to  those  shown  in  contact  with  the  teeth, 
and  renewed  traction  produced  by  turning  the  nut.  Succes- 
sive bendings  and  direct  screw  traction  will  soon  bring  the 
backward  tooth  forward  into  line  (see  Fig.  68),  where  it  will  be 
retained  perfectly  by  the  same  regulating  fixture. 

By  suitably  punching  and  banding  a  piece  of  No.  39,  simi- 
lar simple  rectifications  may  be  cjuickly  accomplished,  even 
when  the  teeth  on  either  side  are  to  be  pushed  apart  by  the 
wedging  pressure  of  the  inclined  sides  of  the  bent  bar. 

ARCH-BAR  EXEMPLIFICATIONS. 

No.  35,  Fig.  69,  is  the  threaded  arch  bar  on  which  are  six 
clutch  nuts.  No.  22.  The  No.  8  is  a  molar  double-socket 
clutch  band;  the  Nos.  13  are  single-socket  clutch  bands,  while 
No.  49  is  a  double-socket  screw  clutch  band. 

In  Fig.  70  is  shown  No.  8  fitted,  wired,  and  cemented  upon 
an  upper  right  first  molar.  No.  13  is  likewise  fixed  upon  the 
upper  right  cuspid,  and  there  is  also  secured  on  the  upper  left 
lateral  another  button  band,  No.  13.  Upon  the  upper  left  first 
molar  a  screw  clutch  band,  No.  49,  is  screw  clamped. 

Upon  the  arch  bar  No.  35  six  Nos.  22  have  first  been  screwed 
into  the  positions  shown  in  Fig.  69,  and  two  bar  end  caps.  No. 
34,  fixed  on  the  ends  of  the  bar. 

This  is  then  ready  to  be  bent,  placed,  and  adjusted  in  the 
position  shown  in  Fig.  70.  The  open  sockets  of  the  bands 
are  specially  designed  to  make  easy  the  passing  of  the  bar 


TEETH    REGULATION. 


ST. 


tliroiigh  the  slots  into  the  sockets,  wherein  it  is  then  secured 
by  means  of  the  peculiar-shaped  nuts  No.  22. 

Fic.  69. 


(Nos   8  49,  I,;,  13,  35,  22,  22,  22,  22,  22,  22,  34,  34.) 

In  the  present  instance,  illustrated  in  Fig-.  70,  the  arch  bar  is 
shown  to  have  been  readily  placed  in  the  socketed  clutches  of 
the  molar  and  cuspid  l^ands,  and  operatively  secured  therein  by 
turning  the  nuts  with  the  wrench  No.  29.  Manifestly  the  turn- 
ing of  the  distal  nuts  of  the  anchor  teeth  bands  will  drag  the 
ciispids  both  inward  and  rearward,  and  the  turning  of  the 
mesial  nuts  will  also  force  the  cuspids  backward.  Simulta- 
neous pressure  on  the  rubber  or  wood  block  will  press  the 
rio-ht  central  inward  with  a  rotative  action. 


58  KNAPP    SYSTEM. 

Independent  traction  of  the  right  lateral  and  left  first  bi- 
cuspid may  be  effected  by  means  of  the  wire  ligatures,  the 
twisted  ends  of  which  may  with  pliers  be  given  operatively  tor- 
sional strain.  The  engagement  of  the  wires  with  the  screw 
threads  affords  means  for  giving  any  desired  lateral  direction 
to  the  drag.  Locating  the  twisting  stress  on  an  outside  con- 
tact with  the  bar  will  be  more  effective  than  the  inside  posi- 
tions chosen  for  clearness  of  illustration. 

The  grouping  of  these  several  modes  of  arch  bar  regulation 
in  this  Fig.  70  briefly  presents  for  selection  any  one,  or  all,  of 
them  to  meet  the  requirements  of  a  similar  case  in  hand. 


Fig.  71. 


V 

(Nos.    8,  49,  22,  22,  22,  22,  13,  3,   12,  5,  35,  39,  39,  38,  38.) 

Another  way  of  producing  traction  in  place  of  ligatures  is 
seen  in  Fig.  71.  Studded  bands  Nos.  3  and  5  are  fixed  on  the 
lateral  and  cuspid.  Pieces  of  No.  39  are  punched  and  bent  as 
seen  at  A.  These  are  hooked  onto  the  bar  35,  and  by  retain- 
ing nuts  38  coupled  to  the  studs,  as  shown  in  the  illustration. 
When  the  limit  of  tractive  action  by  the  turning  of  the  nuts 
has  been  reached,  the  hooks  are  removed,  bent  somewhat 
shorter,  and  replaced.  Repetitions  of  this  process  will  bring 
the  teeth  into  line  ready  for  retainers. 

The  arch  bar,  35,  may  be  employed  in  rotative  action,  as  ex- 
emplified in  Fig.  72.  Fix  double-socket  bands  on  the  molars, 
a  single-socket  band  on  the  right  cuspid,  and  studded  bands  on 
the  right  central  and  left  cuspid.  Turn  a  clutch  nut  22  round 
end  ahead  well  onto  the  arch  bar,  following  with  a  No.  27,  and 
two  22's  on  that  side,  as  also  two  on  the  other  side.     Place  the 


TEETH    REGULATION. 


59 


bar  in  the  several  socket  clutches,  and  with  loops  of  wire 
around  the  studs  twist  the  wire  ends  tig^ht  on  the  bar  and  on 
No.  2.^.     A  careful  consideration  of  the  illustration  will  make 

Fig.  "72. 


(Nos.  S,  12,  5,  4,  35,  22,  27,  8,  22,  22,  22,  22.) 

it  evident  that  the  proper  turning  of  the  nuts  on  the  right  molar 
band  socket  will  rotate  the  central  and  aid  the  corresponding 
rotative  action  on  the  cuspid  caused  by  turning  the  nuts  on  the 

Fig.  yz. 

J 


(Nos.  8,  12,  3,  8,  35,  22,  22,  22,  22.) 


socket  of  the  left  molar  band.  At  the  same  time  a  twisting 
traction  of  the  wire  ligature  on  the  right  second  bicuspid  will 
press  inward  the  right  cuspid. 


(JO 


KNAPP    SYSTEM. 


Fig.  73  excm])lities  the  operation  of  an  arch  bar  Xo.  35 
when  appHed  to  some  forms  of  irregular  inferior  teeth.  In 
the  present  case,  after  Nos.  8,  12,  3,  and  8  (Nos.  50,  50  might 
replace  the  Nos.  8)  had  been  fixed  on  the  respective  teeth,  an 
arch  bar  No.  35  provided  with  four  No.  22's  (see  Fig.  58)  was 
bent  to  properly  engage  the  socket  of  the  band  on  the  cuspid, 
and  under  the  stud  of  the  band  on  the  lateral,  wdiile  resting  in 
the  clutches  of  the  molar  bands.  Then  suitably  turning  the 
clutch  nuts  will  force  outward  the  cuspid,  and  so  act  on  the 
lateral  as  to  push  it  outward,  and  at  the  same  time  partially  ro- 
tate it,  together  with  the  central  against  which  it  impinges. 
The  left  cuspid  could  then  be  pressed  into  line  by  an  arch  bar 
combination  similar  to  that  shown  in  Fig.  70  in  action  on  the 
right  cuspid. 

THE  STUD  BAR  AND  NUT. 
Fig.  74- 


Since  the  publication  of  the  first  edition  of  this  work,  there 
have  been  some  improvements  devised,  and  some  changes  sug- 
gested by  experience. 

The  organization  shown  magnified  in  cross-section  by  Fig- 
17  and  in  position  by  Fig.  18,  while  operative  in  many  in- 
stances, has  been  occasionally  inadequate  in  some  obstinate 
cases  whereon  strong  pressure  would  effect  some  degree  of  un- 


TEETH    REGULATION.  6l 

desirable  rotation  in  addition  to  the  back  or  forth  tipping- 
movement  of  the  irregular  tooth. 

A  careful  consideration  of  the  illustrative  Figs.  74  and  75 
will  make  evident  the  fact  that  in  the  new  stud  bar  No.  53  and 
stud  bar  nut  No.  54  we  now  have  means  for  effecting  a  tip- 
ping movement  without  rotation  in  any  actual  instance.  In 
Fig.  74  the  magnified  members  exhibit  the  operative  functions 
of  the  new  appliances  Nos.  53  and  54,  which  couple  the  stud 
of  Xo.  5  to  the  clutch  of  No.  49  in  such  a  way  as  to  permit 
optional  pull  or  push  action  on  the  tooth  to  be  moved,  with- 
out anv  rotative  stress,  while  surely  effecting  the  desired  tip- 
ping mo\"ement  of  the  tc^oth  crown  in  a  progressive  and  re- 
tentive manner. 

Fig.  75. 


(Nos.  43,  49.  53.  54.  22,  22.) 

In  an  illustrative  example  like  Fig.  74,  a  studded  band 
No.  5  was  fitted  on  the  bicuspid  and  a  No.  49  on  the  molar. 
The  stud  bar  No.  53  and  nut  No.  54  were  adjusted  on  the 
stud  of  No.  5,  the  bicuspid  was  dried  and  kept  dry,  while  with  a 
little  cement  around  its  inner  surface  the  band  was  pressed 
tight  upon  the  bicuspid,  at  the  same  time  the  bar  rested  in  the 
clutch  of  the  molar  band,  ready  for  operative  action  after  the 
setting  of  the  cement. 

Pursuing  the  same  course  with  a  studded  screw-band  instead 
of  No.  5,  the  cement  may  be  omitted,  and  an  immediate  ap- 
plication of  the  stud  bar  effected,  as  shown  in  Fig.  75. 

By  turning  54  tight  on  53,  and  suitably  turning  the  22's  the 
tooth  may  be  tipped  forward  or  Ijackward  (see  dotted  lines 


62 


KNAPP    SYSTEM. 


^i§'-  75)  without  any  rotative  movement  whatsoever.  The 
device  is  both  simple  and  strong;  affording  another  example 
of  the  adaptable  usefulness  of  the  studded  bands. 


In  the  case  shown  by  Figs.  76  and  yj  (the  cut,  Fig.  76,  erro- 
neously shows  the  partially  erupted  cuspids  behind  the  laterals, 
instead  of  above  and  lapping  them,  as  in  the  model),  the  first 
bicuspids  were  extracted  and  studded  bands  Nos.  3  cemented 


(Nos.  3,  50,  53,  54,  22,  22,  34,-3,  51,  53,  54,  22,  22,  34.) 

on  the  cuspids.  Screw-bands  Nos.  50  and  51  were  fixed  on 
the  molars,  and  stud  bars  No.  53,  with  stud  bar  nuts  No.  54, 
were  applied  as  shown  in  Fig.  'jj. 

By  suitably  turning  the  nuts,   Nos.  22,  and  from  time  to 
time  bending  the  slightly  flattened  stud  bars,  to  exert  inward 


TEETH    REGULATION,  03 

spring  action  on  the  retrograding  cuspids,  they  were  simulta- 
neously moved  backward  and  inward  into  line;  the  long  screws 
of  the  screw-bands  being  bent  into  contact  with  the  second 
bicuspids  to  prevent  rotative  stress  on  the  molars  due.  to  the 
spring  action  of  the  stud  bars. 

REINFORCED  ANCHORAGE. 

In  this  instance  the  uppei  right  outward  cuspid  and  the  left 
inward  lateral  were  to  be  moved  into  line.  The  lateral  had  a 
No.  3  band,  the  cuspid  a  No.  5  band,  and  the  right  first  molar  a 
No.  8  band,  wired  and  cemented  as  seen  in  Fig.  78.     On  a  No. 

Fig.  78. 


(Nos.  3,  5,  8,  50,  31,  23,  22,  20,  23,  25,  21,  24,  53,  54,  22,  22.) 


50  band  were  first  screwed  Nos.  31,  23,  and  22,  and  the  band 
fixed  on  the  right  second  molar  as  shown.  A  jack-screw  was 
then  attached  to  31  and  3,  and  pressure  from  the  reinforced 
anchorage  exerted  against  the  lateral  in  the  direction  of  the 
arrow.  A  like  pushing  or  pulling  action  on  a  left  central,  cus- 
pid, bicuspid,  or  molar  could  be  based  on  this  firm  duplex  an- 
chorage. This  is  also  serviceable  in  the  case  of  the  cuspid, 
on  the  band  stud  5  of  which  a  stud  bar  No.  53  is  fixed  by  the 
stud  bar  nut  No.  54.  the  other  end  of  the  bar  entering  the 
clutch  of  No.  50.  By  turning  the  nuts  22,  22  on  the  bar.  trac- 
tive action  on  the  cuspid  may  be  employed,  and  by  from  time 
to  time  removing  and  slightlv  bendino-  the  bar  its  resilience 


64 


KNAPP    SYSTEM. 


or  Spring  will  press  the  cuspid  inward  so  that  its  movement 
into  line  may  be  completed  by  this  stud  bar  action  alone.  It  is 
noteworthy  that  the  two  molars  coupled  by  means  of  the  long 
screw  of  50  resist  firmly  the  torsional  stress  of  the  spring  finger 
action  of  the  bent  stud  bar. 

Fig.  79. 


In  Fig.  79  is  shown  a  case  of  remarkable  protrusion  wherein 
the  lower  central  incisors  indented  the  gums  on  a  line  from 
cuspid  to  cuspid. 

The  superior  first  bicuspids  were  removed,  and  studded 
bands  Nos.  4  were  cemented  on  the  central  incisors  as  shown  in 
Fig.  81.      Screw  bands  Nos.  50  were  then  fixed  upon  the  first 


Fig.  80. 


f": 


No.  55. 


No.  56. 


molars.  Two  bar  hooks  Nos.  55,  see  Fig.  80,  are  (one  on  each 
side)  to  be  slid  head  first  upon  an  arch  bar,  No.  35,  and  fol- 
lowed by  lock  nuts  Nos.  23  to  retain  the  hooks  in  the  positions 
as  shown  by  Fig.  81.  Two  more  bar  hooks  are  then  slid. 
hooks  first,  on  the  bar  and  kept  from  sliding  off  by  bar-end 
caps  Nos.  34.  Two  short  pieces  of  No.  39  are  to  be  punched  as 
seen  at  A,  Fig.  80,  cut  with  plate  nippers  as  seen  at  B,  and 
shaped  into  limit  hook  form  like  C.     The  prepared  arch  bar 


TEETH    REGULATION. 


65 


may  then  be  placed  in  position,  and  the  hooks  coupled  by- 
springs,  Nos.  56,  shown  separately  in  Fig.  80.  Two  limit 
hooks  (C)  are  then  fixed  upon  the  band  studs  of  the  centrals 
by  retaining  nuts  Nos.  38  as  shown  by  Fig.  81  in  the  labial 
aspect  of  C,  that  indicates  clearly  the  limiting  function  of  the 
hook  C,  Fig.  80. 

The  illustrations  and  descriptions  should  make  apparent  the 
fact  that  by  repeatedly  screwing  the  nuts  23  away  from  the 
spiral  springs,  this  tension  will  draw  the  oral  teeth  backward 
into  position.  Rubber  rings  may  likewise  then  be  used  as 
shown  at  D,  Fig.  81,  but  the  springs  are  preferable  from  every 

point  of  view. 

Fig.  81. 


(Nos.  4,  4,  50,  50,  35,  55,  55,  23,  23,  55,  55,  34,  34,  56,  56. ) 

The  bar  can  be  taken  from  the  mouth  and  replaced  in  a 
minute  by  first  detaching  the  springs,  sliding  the  rear  hooks 
out  of  the  clutches  and  loosening  the  retaining  nuts;  then  re- 
versing these  steps  will  suffice  to  readily  replace  the  bar  for 
action. 

Of  course  the  positive  screw  traction  can  be  produced  by 
substituting  for  the  springs  and  their  hooks  the  bar  and  nuts 
shown  in  Fig.  70,  but  the  variable,  yet  controllably  constant 
resilient  action  of  this  Fig.  81  organization  has  proven  useful 
in  regulative  movements  of  like  magnitude. 

5 


66 


KNArP    SYSTEM. 


MAJOR    PROTRUSION. 

In  cases  of  major  protrusion  when   the  oral  teeth,  some- 
times even  inchiding  the  l)icuspids,  are  to  l)e  retracted  simul- 
taneously, or  partially  so,  merely  dental  anchorage  is  insuf- 
ficient and  a  resort  to  the  occipital  base  becomes  necessary. . 
A  case  in  point  is  shown  by  Fig.  82.     The  early  loss  of  the 

Fig.  82. 


Fig.  83. 


(NOS.  58,  35,  s\,  5%,  5%,  flV.  56.) 


upper  first  molars  and  the  obviously  very  considerable  protru- 
sion of  the  six  anterior  teeth,  make  this  an  illustrative  instance 
of  the  applicability  of  the  protrusion  bow  organization  shown 
in  Fig.  83. 


TEETH    REGULATION. 


67 


PROTRUSION   BOW. 

The  protrusion  bow  No.  58,  shown  separately  in  Fig.  84, 
has  a  pivoted  central  standard  A,  in  the  socket  of  which  the 
split  chuck  B  is  conically  seated.  This  chuck  is  transversely 
bored  and  threaded  to  receive  the  arch  bar  No.  35.  In  opera- 
tion the  arch  bar  is  to  be  secured  upon  the  teeth  in  a  manner 
similar  to  that  shown  by  Fig.  81.  The  chuck  B  is  then  sprung 
onto  No.  35,  and  the  standard  A  telescoped  upon  the  chuck, 
which  by  cone  action  is  made  to  grip  the  arch  bar  at  any  an- 
terior location;  usually  a  central  position  as  seen  in  Fig.  83. 
Any  suitable  head  gear  or  cap  (that  supplied  by  Dr.  E.  H. 
Angle  is  an  excellent  one)  may  be  connected  by  elastic  bands, 

Fig.  84. 


No.  58. 


or  straps  and  buckles,  with  the  bow  ends  to  produce  retractive 
pressure  on  the  arch  bar;  either  supplemental  to  the  No.  56 
action,  or  independently  of  the  springs. 

The  protrusion  bow  rocks  on  its  pivot  to  prevent  shocks 
when  the  bow  ends  are  pressed  upon  by  the  pillow  or  other- 
wise, and  also  provides  for  unswerving  pressure  on  the  stand- 
ard, which  would  act  latero-obliquely  if  it  rocked,  instead  of 
being  rigidly  gripped  to  the  bar  by  the  threaded  chuck  B,  Fig. 
84. 

The  split-chuck  grips  the  bar  firmly  under  retractive  pres- 
sure, which  when  relaxed  somewhat,  does  not  detach  the  bow, 
but  permits  adjustive  rotation  and  fixation  of  the  chuck  on  the 
bar  to  direct  the  retractive  force  upward  to  counteract  the 


68 


KNAPP    SYSTEM. 


usual  extension  of  the  centrals  and  laterals  sinuiltaneously  with 
the  protrusive  correction.  It  also  provides  for  downward  pres- 
sure to  increase  the  extension,  if  the  teeth  are  to  be  lengthened 
wdiile  being  pressed  backward, — a  combined  movement  pro- 
vided for  and  sometimes  recjuired. 

To  remove  the  bow,  or  change  its  relations,  it  is  only  neces- 
sary to  detach  the  bow  ends  from  the  head  cap  and  slip  the 
standard  from  the  chuck.  This  too  is  readily  sprung  ofi  the 
bar  by  a  slight  lateral  movement. 

Fig.  85. 


Fig.  86. 


An  instance  of  this  sort  of  complex  major  protrusion  is 
shown  by  Figs.  85  and  86.  In  this  case  the  procedure  would 
be  as  follows: 

Fit  and  cement  tight  on  the  right  central  a  No.  4  band, 
placing  the  stud  labio-mesially,   and  near  the  gum  margin. 


TEETH    REGULATION. 


69 


Fix  two  No.  50  bands  on  the  first  molars.  Place  a  No.  35 
with  four  22's  on  it  (see  Fig.  58)  so  that  the  l)ar  will  rest  on 
the  right  central  aljove  the  stud.  Press  the  bar  into  the 
clutch  sockets  of  the  50's,  turning  in  the  22's  to  produce 
traction  on  the  right  central.  Then  spring  the  split  chuck  B 
of  No.  58  onto  the  35  mesially,  near  the  stud  of  No.  4,  slide  B 
into  its  socket  in  the  standard  A  of  the  protrusion  bow  No. 
58,  and  attach  to  the  bow  hooks  the  elastic  bands  of  a  head- 
cap;  that  of  Dr.  E.  H.  Angle  shown  on  page  71,  Fig.  85,  of  the 
Angle  System,  is  an  excellent  head  gear. 


(Nos.  58,35,  /j.) 


By  inclining  somewhat  backward  the  standard  A  of  No.  58 
and  suitably  adjusting  the  retractive  force  so  that  the  lower 
elastic  band  shall  draw  from  the  lowest  location  on  the  oc- 
cipital base,  an  eruptive  action,  additional  to  the  retractive  ex- 
ertion, may  ensue,  and  the  central  be  drawn  down  as  well  as 
back.  A  yet  lower  line  of  retractive  draft  may  be  obtained  by 
leading  strong  elastic  bands  from  the  protrusion  bow  hooks 
to  the  buttons  on  the  chin  retractor  illustrated  in  Fig.  92  on 
page  76  of  Dr.  E.  H.  Angle's  book  descriptive  of  the  Angle 
System. 


70  KNAPP    SYSTEM. 

As  a  result  of  the  judicious  placing",  adjusting,  and  operation 
of  these  appHances,  the  superior  oral  teeth  including  the  bi- 
cuspids of  this  patient  may  be  symmetrically  retracted,  and  re- 
tained in  their  proper  positions. 

The  protrusion  bow  and  arch  bar  organization  shown  in 
Fig.  87  will  serve  in  combination  with  suitable  bands  for  cases 
of  minor  protrusion;  but  not  seldom  the  supplemental  hooks 
55  and  springs  56  of  the  Fig.  83  assemblage  will  be  found 
necessary,  as  in  the  case  of  Fig.  82. 

DUPLEX  BALL-BAR  JACK-SCREW. 
The  form  of  jack-screw  shown  in  Fig.  88  will  be  found  con- 
venient in  many  cases  where  a  tooth  on  each  side  of  the  arch 
is  outside  or  inside  the  arch.  As  will  be  seen  in  the  figure,  the 
upper  cuspids  of  either  side  are  inside  the  lower  teeth,  and  a 
jack-screw  composed  of  parts  Nos.  24,  21,  26,  57,  23,  24  is 
attached  to  No.  5  bands  on  the  cuspids.     By  turning  No.  26 

Fig.  88. 


(Nos.  5,  24,  21,  26,  23,  57,  74,  5.) 

Fig.  90. 
Eight-hand  Threaded  Ball-Bar  No.  57. 

(Nos.  5,  24,  21,  23,  25,57,  24,  4-)  No.  57. 

in  the  proper  direction,  the  jack-screw  will  expand,  and  both 
the  cuspids  be  forced  outward  into  their  proper  positions. 
This  same  jack-screw  organization  will  also  draw  into  position 
teeth  that  are  outside  the  line  of  the  arch,  and  will  apply  to  all 


TEETH    REGULATION.  7I 

teeth  anterior  to  the  first  molars  (upper  and  lower).  If  the 
reach  is  long,  Xo.  25,  see  Fig.  89,  may  be  used  in  place  of  No. 
26,  This  form  of  jack-screw  differs  from  those  previously 
shown  in  that  the  right-hand  threaded  ball-bar  No.  57,  see 
Fig.  90,  replaces  the  short  T  bar  No.  20;  thus  allowing  both 
ends  of  the  appliance  to  be  attached  to  studded  bands. 

It  should  be  carefully  noticed  that  in  the  illustrations  of 
the  several  separate  ball  and  T  bars,  their  relations  to  the 
right-  and  left-hand  threaded  nuts  25  and  26  are  shown  by  the 
positional  tendencies  of  the  screw  ends.  For  example,  in 
Fig.  90  the  screw-end  of  No.  57  is  shown  in  the  proper  posi- 
tion to  be  screwed  into  the  right-threaded  end  of  25,  Fig.  89. 
The  T  bars  19  and  20  are  also  shown  in  Hke  right  positions, 
while  21  and  33  are  seen  in  positions  for  being  turned  to  the 
left  into  the  left-threaded  ends  of  25  or  26. 

Attention  is  directed  to  these  indications  to  insure  the  cor- 
rect assemblage  of  these  related  members  in  order  to  avoid 
inadvertent  entries  of  right-hand  screws  into  left-hand  nuts, 
or  the  reverse  procedure,  which  would  also  wreck  the  threads 
of  the  accurately  made  and  adapted  appliances. 

The  expeditious  and  extensive  adoption  of  these  appliances 
has  greatly  encouraged  the  author  to  expect  a  further  favor- 
able reception  for  some  later  devices  described  and  illustrated 
in  this  enlarged  second  edition,  which  is  gratefully  submitted 
for  the  consideration  of  the  profession  that  is  ever  ready  to  ap- 
preciate any  real  advancement  in  the  means  and  methods  for 
facilitating  the  almost  always  perplexing  problems  of  teeth 
regulation. 


72 


KNAPP    SYSTEM. 


LIST    OF    NUMBERED    APPLIANCES, 
MEASUREMENTS,  AND  PRICES. 

PalcTiled  January  iS,  1898,  January  24,  iSjS,  September  12,  1S99. 


The  cuts  show  nearly  exact  sizes,  except  those  inclosed  in  brackets,  which 
are  magnified  to  show  details  of  the  small  parts. 


OC 1 X 


Studded    Bands,    Nos.  i    to   6, 
inclusive, 


Double  Socket  Clutch 
Bands,  Nos.  7  to  10, 
inclusive, 


Single   Socket    Clutch    Bands, 
Nos.  II  to  14,  inclusive, 


Price,  Each. 
50  cents. 


75  cents. 


60  cents. 


Measures. 


Bite  Bands,  Nos.  15  to 
18,  inclusive, 


50  cents. 


Measures. 

The  S.  S.  'White  Dental  Mfg.  Co.,  Sole  Agent. 


TEETH    REGULATION. 


i® 


Long  T  Bar.  No.  19, 
Short  T  Bar,  No.  20, 
Ball  Bar,  No.  21, 

Clutch  Nut,  No.  22, 

Lock  Nut,  No.  23,  (g] 

Ball  Cap,  No.  24,  ^ 

Long  Right  and  Left  Threaded  Nut,  No.  25, 
Short  Right  and  Left  Threaded  Nut,  No.  26. 


lllimilllnillllliiiiiiiiiiiiiiiiiiiiiiiiimmimiiiiiiiimiim,immMiia 


73 

B^]      50  cents. 
45  cents. 
ijuiiiiiuiiiiiiiiuijiuiii^  I       50  rents 


25  cents. 

20  cents. 
75  cents. 


iSi^^^      75  cents. 
60  cents. 


Square  T  Socket,  No.  27, 


Round  T  Socket 
Clutch  Bar  with 
Clutch  Nut,  No. 
28, 


Wrench,  No.  29, 


C^K> 


I^BliiMiSnii 


^^ 


Band  Wire,  No.  30, 


Single  Auxiliary  T  Socket,  No.  31, 


75  cents. 


$L00. 


15  cents. 


25  cents. 


75  cents. 


L  w^^sEiiiiiiiiimiiiiiii 


Double  Auxiliary  T  Socket,  No.  32, 
Straight  Neck  Ball  Bar,  No.  33, 
Bar-End  Cap,  No.  34,         ® 


$1.00. 

]      50  cents. 

25  cents. 
The  S.  S.  'White  Dental  Mfg.  Co.,  Sole  Agent. 


74 


KNAPP    SYSTEM. 


Arch  Bar, 
Threaded, 
No.  35, 


$1.00. 


Perforated  Stud,  No.  36,  ^ 

Retaining  Clamp,  No.  37, 

Retaining  Clamp  Nut, -No.  38 

Retaining  and 

Connecting  Band, 

No.  39, 

Left-hand  Threaded  T  Bar,  No.  40 

Screw  Band,  Studded,  No.  41, 


" 

"    42, 

Old  No 

" 

"    43, 

42 

" 

"    44, 

Single 
1 1 

Socket  Clutch, 

11            II 

No, 

.  45, 
46, 
47, 
48, 

43 
44 

"      Double    " 


1.00. 
1.00. 
1.00. 
1.00. 

1.00. 
1.00. 
1.00. 
1.00. 


The  S.  S.  White  Dental  Mfg.  Co.,  Sole  Agent. 


TEETH    REGULATION. 


75 


NEW  SCREW  BAND  MEASURES, 


49 


50 


51 


52 


Stud  Bar,  No.  53, 


50  cents. 


Stud  Bar  Nut,  No.  54,  ^         No.  54, 


75  cents. 


Bar  Hook,  No.  55, 


C^^         25  cents. 


Spring,  No.  56,  per  pair, 


OiBBillO      25  cents. 


Right-hand  Threaded  Ball-Bar  No.  57. 


No.  57. 


Price $0.50 


Protrusion  Bow  No.  58. 


Price  $2.50 

The  S.  S.  "White  Dental  Mfg.  Co.,  Sole  Agent. 


76 


KNAPP    SYSTEM. 


^ 


Pat.  JanV.  i8'-«  1898.  ^'m.':^^^  "tii£g:^  Pat.JanV.z^- 

IMMEDIATELY     APPLICABLE 

fEGULATINa  BeYICEi 

NO     SOL^DEF^illXlCB 
READILY  ADJUSTED 


1399 


o, 


The  jB.^. White  Dental  Mfg.  Q 

i         SOLE      AGENT    

PHILADELFI-llA.NEV/  YORK.  DOSTON.  CM  ICAGO. BROOKLYN  . 

ATLANTA.  ROCHESTER  .  BERLIN. BU  ENDS  AIRES. 

ST.PETERSBURO. 


A  selected  set  in  a  box  (see  illustration)  will  suffice  for  use  in  many  cases. 
It  includes  Nos.  3,  4,  5,  8.  20,  21,  23,  24.  25,  29,  30,  53,  54,  and  three  No.  22. 

This  set  contains  the  Stud  Bar  No.  53  and  Stud  Bar  Nut  No.  54,  which 
are  recent  improvements  for  use  instead  of  the  No.  19  and  No.  27  combina- 
tion of  the  set  shown  in  the  first  edition  of  this  work,  and  not  now  supplied 
as  a  set. 

Price  per  set  in  the  box $8.00 

The  box  will  conveniently  contain  additional  parts,  which  are  always  to  be 
ordered  by  their  identifying  numbers. 

The  purchaser  from  us  of  a  set  at  its  retail  price  will  be  supplied  with  a 
paper-covered  copy  of  Dr.  Knapp's  Descriptive  Book. 

Price  of  Book,  separately $0.50 

The  descriptive  matter  and  the  illustrations  refer  to  the  appliances  by  their 
denoting  numerals,  so  that  the  cost  of  the  several  combinations  can  be 
readily  ascertained. 

The  devices  are  finely  made  of  high  grade  German  silver,  accurately  inter- 
changeable, and  electro-gilt. 

Manufactured  under  the  author's  supervision. 

The  S.  S.  "White  Dental  Mfg.  Co.,  Sole  Agent. 


TEETH    REGULATION.  "]"] 

Plate-Nipping  Punch,  No.  3,  Small.    Retaining  Band  Punch,  No.  12. 


78 


KNAPP    SYSTEM. 


DR.  H.  H.  BURCHARD'S       COLLAR  AND  CROWN 


CONTOURING  PLIERS. 


SCISSORS. 


Suggested  by  Dr.  J.  H.  Beebee. 


No.  II. 


The  pliers  answer  well  for  bar  and  retaining  band  bending,  and  the  scissors 
serve  for  trimming  the  Bite  Bands,  etc. 


COLUMBIA  UNIVERSITY  LIBRARY 

This  book  is  due  on  the  date  indicated  below,  or  at  the 
expiration  of  a  definite  period  after  the  date  of  borrowing, 
as  provided  by  the  rules  of  the  Library  or  by  special  ar- 
rangement with  the  Librarian  in  charge. 

DATE  BORROWED 

DATE  DUE 

DATE  BORROWED 

DATE  DUE 

1 

C2ei239)MIOO 

Teeth  reqiil.-innc 


2002446944 


